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Peds > Fetal Circulation > Flashcards

Fetal Circulation Flashcards

0
Q

Where does nutrient and waste exchange between the mother and fetus occur?

A

Placenta

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1
Q

Fetal organs not functional until birth

A

Lungs
Kidneys
GI tract

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2
Q

Carries blood away from fetus to placenta

A

Umbilical artery

-low O2 content, carries waste and CO2

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3
Q

Carries blood from placenta to fetus

A

Umbilical vein

-carries nutrient and O2, high O2 content

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4
Q

Umbilical arteries and veins branch into these that are located in the intervillous space in the placenta

A

Fetal capillaries

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5
Q

Spaces filled with maternal blood from uterine arterioles, drained by uterine veins

A

Intervillous spaces

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6
Q

How much higher is the concentration if hemoglobin in fetal blood compared to adult?

A

50% higher

Can carry 30-35% more oxygen

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7
Q

Exchange of gases in the placenta

A

Exchange of CO2, O2, CO (via diffusion)

  • 20-30ml/min O2 extracted
  • short interruption of blood flow can be fatal to fetus
  • depends on delivery not diffusion
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8
Q

Exchange of nutrients in placenta

A

Amino acids, free fatty acids, carbohydrates, vitamins

Exchange is rapid and increases throughout pregnancy

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9
Q

Transfer of maternal antibodies in placenta

A

Late first trimester: fetus makes component of complement, start of immunologic competence
IgG can cross placenta, passive immunity

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10
Q

Hormone production in the placenta

A

4th month: placenta produces enough progesterone to maintain pregnancy if corpus luteum should fail
Continues to produce estrogenic hormones (estriol, rises until end of pregnancy)

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11
Q

Umbilical arteries

A

From fetus to placenta
Have 2
Branch from internal iliac arteries
Saturation about 58%

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12
Q

Umbilical vein

A

Have 1
Saturation about 80%
Goes to liver of fetus and divides into hepatic portal vein (to liver, 1/3) and ductus venous (to IVC, 2/3)

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13
Q

Blood in the IVC

A

Oxygenated blood via ductus venosus meets deoxygenated blood from lower body
Saturation drops to 67%

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14
Q

Blood path that enters IVC

A

IVC–>RA–>Foramen ovale–>LA–>LV–>Aorta–>perfused brain and myocardium

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15
Q

Blood path that enters SVC

A

SVC–>RA–>RV–>PA–>ductus arteriosus–>descending aorta–>perfused fetal tissue

16
Q

Only fetal vessel to carry fully oxygenated blood

A

Umbilical vein

17
Q

3 shunts present in fetal circulation that usually close after birth

A

Ductus arteriosus
Foramen ovale
Ductus venosus

18
Q

Umbilical arteries after birth

A

Get contraction in smooth muscle walls caused by thermal and mechanical stimuli and change in oxygen tension
Functionally close after birth and fill with connective tissue
Distal portion becomes fibrous cords (medical umbilical ligaments)
Complete closure takes 2-3 months

19
Q

Umbilical vein after birth

A

Collapses shorty after umbilical arteries
Blood from placenta may enter newborn for some time after birth
Remains as the ligamentum teres hepatis (lower margin of falciform ligament that attaches umbilicus to liver)

20
Q

Ductus venosus after birth

A

Collapses
Remains as ligamentum venosum (fibrous cord on inferior surface of liver)
Patent ductus venosus extremely rare

21
Q

Foramen ovale after birth

A

Closes after birth becoming fossa ovalis:

  1. First breath causes lungs to expand, increases BF to lungs
  2. XBlood returning to LA increases pressure in LA (pressure in RA falls)
  3. Septum primum gets pushed against septum secundum, closing formamen ovale (can be reversible first days of birth because crying baby can create a right to left shunt causing cyanosis)
  4. Constant apposition leads to fusion of septa
  5. Permanent closure within first year of life
22
Q

Patent foramen ovale

A

Foramen ovale that has not closed after a year
27% prevalence
Most patients asymptomatic

23
Q

Ductus arteriosus after birth

A

Closes via contraction of muscular wall after birth (mediated by bradykinin)
After first breath, lungs fill with air instead of fluid, pulmonary BF increases
Ductus protects pulmonary vasculature from overload, closes via vasoconstriction (1-2 days after birth)
Becomes ligamentum arteriosum
Complete obliteration takes 1-3 months

24
Q

Umbilical arteries become:

A

Medial umbilical ligaments

25
Q

Umbilical vein becomes:

A

Ligamentum teres (round ligament)

26
Q

Ductus venosus becomes:

A

Ligamentum venosum

27
Q

Foramen ovale becomes:

A

Fossa ovalis

28
Q

Ductus arteriosus becomes:

A

Ligamentum arteriosum

Peds (13 decks)

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