GOOD AFTERNOON

Ms. Hemlata
Tutor
College of Nursing, AIIMS Jodhpur
 Unit-2 CONTENT
• Female organs of reproduction
• Physiology of menstrual cycle
• Human sexuality
• Fundamental of reproduction-gametogenesis ,ovulation, fertilization ,
implantation
• Development of the embryo, Development of placenta at term ,
structure ,functions and placemntal circulation, fetal sac
• Amniotic cavity ,amnion and amniotic fluid , Umbilical cord
• Anatomical variations of the placenta and the cord
• Fetal circulation
• Fetal skull ,bones ,sutures and measurements
• Female pelvis
• Review of genetics : genetics ,principles of heredity ,genetic
disorders and counseling ,prevention and prediction of
congenital malformation
Video of life: emotional and
courageous
 FETAL
CIRCULATION
 INTRODUCTION
The fetal circulation is the circulatory system of
a human fetus, often encompassing the entire
fetoplacental circulation that also includes the
umbilical cord and the blood vessel within the
placenta that carry fetal blood.
• The fetal circulation works differently from
that of born humans, mainly because the
lungs are not in use :the fetus obtains oxygen
and nutrients from the mother through the
placenta and the umbilical cord.
Placental
role
 Placental role
The core concept behind fetal circulation is that fetal
hemoglobin has a higher affinity for oxygen than
adult hemoglobin, which allows a diffusion of oxygen
from the mother’s circulatory system to the fetus.

The circulatory system of the mother is not directly

connected to that of the fetus, so the placenta
function as respiratory center for the fetus as well as
a site of filtration of plasma nutrients and wastes
Water, glucose, amino acids, vitamins, and inorganic salts
freely diffuse across the placenta along with oxygen.
 CIRCULATORY SYSTEM OF THE
BODY
The heart, lungs, and blood vessels make up the
circulatory system of the human body. The heart is the
central pump of the circulatory system, and consists of
following :

Heart chambers
 The atria are the two upper chambers that collect blood as
it flows into the heart.
 The ventricles are the two lower chambers that pump
blood out of the heart to the lungs or other parts of the
body.
Heart valves
 Tricuspid valve
 Pulmonary valve
 Mitral valve
 Aortic valve
Arteries
 Pulmonary artery
 Aorta
 Coronary arteries
Veins
 Pulmonary veins
 Superior and inferior vena cava
 FETAL
CIRCULATION
 FETAL HAEMODYNAMICS
• Fetal blood flow – 400 ml per minutes
• Pressure in the
umbilical artery- 60 ml per Hg
• Pressure in the
umbilical vein-10 ml per Hg
• Fetal capillary in villi-20-40 ml per Hg
 umbilical umbilical
artery vein

• Oxygen saturation 50-60% 70-80%

• Partial oxygen
saturation 20-25% 30-40%
FETAL CIRCULATION
 FETAL CIRCULATION

• The umbilical vein carrying

the oxygenated blood (80%
saturated) from the placenta,
enters the fetus at the
umbilicus and runs along the
free margin of the falciform
ligament of the liver.

• In the liver, it gives off

branches to the left lobe of
the liver and receives the
deoxygenated blood from
the portal vein.
FETAL CIRCULATION
•The greater portion of the
oxygenated blood, mixed
with some portal venous
blood through the ductus
venosus to enter the inferior
vena cava and hence to right
atrium of the heart.

•The terminal part of the

inferior vena cava also
contains the deoxygenated
blood from the caudal parts
of the fetus below the
diaphragm.
FETAL CIRCULATION
 FETAL CIRCULATION

In the right atrium, most of the

blood (75%) is guided towards
the foramen ovale by the valve
of the inferior vena cava and
passes into the left atrium. Here
it is mixed with small amount of
venous blood returning from the
lungs through the pulmonary
veins. This left atrial blood is
passed on through the mitral
opening to the left ventricle.
FETAL CIRCULATION
 FETAL CIRCULATION

Remaining lesser amount of

blood (25%), after reaching
the right atrium via the
superior and inferior vena
cava (carrying the venous
blood from the cephalic and
caudal parts of the fetus
respectively), passes through
the tricuspid opening into the
right ventricle.
FETAL CIRCULATION
 Contd…
• During the ventricular systole, the
left ventricular blood is pumped into
the ascending and arch of aorta and
distributed by their branches to the
heart, head, neck, brain and arms.

• The right ventricular blood with low

oxygen content is discharged into
the pulmonary trunk. Since the
resistance in the pulmonary arteries
during fetal life is very high, the
main portion of the blood passes
directly through the ductus
arteriosus in to the descending aorta
by passing the lungs where it mixes
with the blood from the proximal
aorta.
FETAL CIRCULATION
• The mixed blood is distributed by the
descending aorta and leaves the body by
way of two umbilical arteries. The
deoxygenated blood leaves the body by
way of two umbilical arteries to reach the
placenta where it is oxygenated and gets
ready for recirculation.

• Changes of the fetal circulation at birth

–
The hemodynamic of the fetal circulation
undergoes profound changes soon after
birth due to
(1) cessation of the placental blood flow and
(2) initiation of respiration.
FETAL CIRCULATION
The following changes occur in the vascular
system:
1. Closure of the umbilical arteries:
Functional closure is almost preventing even
slight amount of the fetal blood to drain out.
Actual obliteration takes about 2-3 months.
2. Closure of the umbilical vein:
The umbilical vein forms the ligamentum teres and the ductus venosus
becomes ligamentum venosum.

3. Closure of the ductus arteriosus:

Within few hours of respiration, the muscle wall of the ductus arteriosus
contracts probably in response to rising oxygen tension of the blood
flowing through the duct.
Whereas functional closure of the ductus may occur soon after the
establishment of pulmonary circulation, the anatomical obliteration takes
about 1-3 months and becomes ligamentum arteriosum.

4. Closure of the foramen ovale:

This is caused by an increased pressure of the left atrium combined with
a decreased pressure on the right atrium. Functional closure occurs soon
after birth but anatomical closure occurs in about 1 year time.
FETAL CIRCULATION
CHANGES OF THE FETAL CIRCULATION AT
BIRTH
CONCLUSION
THANK YOU