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There are very few, tiny arteriovenous vascular anastomoses present in TAPS placentas. This distinct angiography is the foundation of the pathogenesis of TAPS. A slow transfusion of blood from the donor to the recipient is made possible by the few tiny anastomoses, which eventually cause very disparate hemoglobin levels.
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.
Reversing flow patterns in arteries and/or veins can also have the same effect, although it is unclear whether this is due to differences in physical or chemical properties of venous vs. arterial flow (i.e. pressure profile and oxygen tension). [10] Another example of the fluidity of arterial-venous identity is that of the intersomitic vessel.
The flow profiles was first derived by John R. Womersley (1907–1958) in his work with blood flow in arteries. [1] The cardiovascular system of chordate animals is a very good example where pulsatile flow is found, but pulsatile flow is also observed in engines and hydraulic systems, as a result of rotating mechanisms pumping the fluid.
As the umbilical vessels are obliterated and the infant starts breathing at birth, the source of oxygen changes from the placenta to the lungs. This major trigger will facilitate the transformation from fetal to postnatal circulation in many ways. First, the ductus venosus was previously kept open by the blood flow from the umbilical vein.
The pumping action of the heart generates pulsatile blood flow, which is conducted into the arteries, across the micro-circulation and eventually, back via the venous system to the heart. During each heartbeat, systemic arterial blood pressure varies between a maximum ( systolic ) and a minimum ( diastolic ) pressure. [ 33 ]
The umbilical arteries are one of two arteries in the human body, that carry deoxygenated blood, the other being the pulmonary arteries. The pressure inside the umbilical artery is approximately 50 mmHg. [4] Resistance to blood flow decreases during development as the artery grows wider. [5]
In response to this, the proportion of umbilical venous blood diverted to fetal heart increases. [25] This eventually leads to elevation of pulmonary vascular resistance and increased right ventricular afterload. [26] [27] [28] This fetal cerebral redistribution of blood flow is an early