THE FETAL CIRCULATION

• The placenta is the source of oxygenation,

nutrition and elimination of waste from the
fetus
• There are several temporary structures in
addition to the placenta and the umbilical
cord.
• That enable the fetal circulation
(1) The ductus venosus
• connects umbilical vein to the inferior
vena cava

(2)The foramen ovale

• the opening between the right and
left atria
(3) The ductus arteiosus –
leads from the bifurcation of the pulmonary
arteries to the descending aorta
(4) The hypogastric arteries
The branch off from the internal iliac
arteries and become the umbilical
arteries when they enter the umbilical
cord
• The fetal circulation takes the following course
a) Oxygenated blood from the placental travels
to the fetus in the umbilical vein
b) The umbilical veins divided in to two
branches
i) one- that supplies the portal vein in the liver
ii) the other the ductus venosus joining the
inferior vena cava
• c) Most of the oxygenated blood that enters
the right atrium
• d) It passes across the foramen ovale to the left
atrium and from here to into the left ventricle,
and then the aorta
• e) The head and upper extremities reserve
approximately 50% of this blood via the
coronary and carotid arteries and sub clavian
arteries
• f)The rest of the blood travels down the
ascending aorta , mixing with deoxygenated
blood from the right ventricle
• g) Deoxygenated blood collected from the
upper parts of the body returns to the right
atrium in the superior vena cava.
• h) Blood that has entered the right atrium
from SVC and IVC pass into the right ventricle
• i) A little blood travels to the lungs in the
pulmonary artery, for their development
• j) Most blood passes through the ductus
arteriosus in to the descending aorta
• This blood also low in oxygen and nutrients is
sufficient to supply the lower body
• It’s also by this means that deoxygenated
blood travels back to the placenta via the
internal iliac arteries , which lead into the
hypogastric arteries which leads into the
umbilical arteries.
 Adaptation to extra uterine life
• At birth- Dramatic alteration to the fetal
circulation( almost immediate changes occur)
• The cessation of umbilical blood flow causes a
cessation of flow in the ductus venosus
• A fall in pressure in the right atrium and closure
of foramen ovale
• A the baby takes the first breath , the lungs
inflates and there is a rapid fall in pulmonary
vascular resistant
• The ductus arteriosus constric due to Bradykinin
released from the lungs on initial inflation
• The effect of Bradykinin is dependent on the
increase in arterial oxygen
• In the term baby , the ductus arteriosus closes
within first few days of birth
• These structural changes becomes permanent
and becomes as follows
1-The umbilical vein becomes the ligamentum
teres
2- The ductus venosus becomes the ligamentum
venosum
3- The ductus arteriosus becomes the
ligamentum arteriosum
4- The foramen ovale becomes the fossa ovalis
• The hypogastric arteries are known as the
obliterated hypogastric arteries expect for the
first few centimeters which remain open as
the superior vesical arteries
• Adaptation to extrauterine life also involves-
• a)Maintenance of a nutritional state through
the establishment of breast feeding
•
• b) Elimination of waste via the kidney and GIT

• c) Temperature control

• Communication developed through parent-

child interaction