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The fetal circulation is composed of the placenta, umbilical blood vessels encapsulated by the umbilical cord, heart and systemic blood vessels. A major difference between the fetal circulation and postnatal circulation is that the lungs are not used during the fetal stage resulting in the presence of shunts to move oxygenated blood and ...
Human embryo at approximately 30 days, showing development of various structures including the yolk sac.From Gray's anatomy. Vasculogenesis is the formation of early vasculature, which is laid down by genetic factors. [7]
The truncus arteriosus and bulbus cordis are divided by the aorticopulmonary septum.The truncus arteriosus gives rise to the ascending aorta and the pulmonary trunk.The caudal end of the bulbus cordis gives rise to the smooth parts (outflow tract) of the left and right ventricles (aortic vestibule & conus arteriosus respectively). [2]
The sinus venosus connects to the fetal circulation. The heart tube elongates on the right side, looping and becoming the first visual sign of left-right asymmetry of the body. Septa form within the atria and ventricles to separate the left and right sides of the heart .
A catheter may be inserted into one of the umbilical arteries of critically ill babies for drawing blood for testing. [6] This is a common procedure in neonatal intensive care, and can often be performed until 2 weeks after birth (when the arteries start to decay too much). [7]
All of these cardiovascular system changes result in the adaptation from fetal circulation patterns to an adult circulation pattern. During this transition, some types of congenital heart disease that were not symptomatic in utero during fetal circulation will present with cyanosis or respiratory signs.
The unpaired umbilical vein carries oxygen and nutrient rich blood derived from fetal-maternal blood exchange at the chorionic villi.More than two-thirds of fetal hepatic circulation is via the main portal vein, while the remainder is shunted from the left portal vein via the ductus venosus to the inferior vena cava, eventually being delivered to the fetal right atrium.
Persistent fetal circulation is a condition caused by a failure in the systemic circulation and pulmonary circulation to convert from the antenatal circulation pattern to the "normal" pattern. Infants experience a high mean arterial pulmonary artery pressure and a high afterload at the right ventricle.