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Cardiovascular > Foetal Circulation and Adaptation > Flashcards

Foetal Circulation and Adaptation Flashcards

1
Q

What is the placenta involved in?

A

Circulation:

  • gas exchange
  • nutrition
  • waste excretion
  • homeostasis
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2
Q

How do foetal lungs differ from adult lungs?

A

they are deflated and fluid filled

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3
Q

How does the foetal liver differ from the adult liver?

A

it has little role in nutrition and waste management

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4
Q

How does blood reach the placenta?

A

via the umbilical arteries

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5
Q

How does blood return from placenta to foetal heart?

A

via the umbilical vein

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6
Q

3 shunts in foetal heart

A

ductus venosus, foramen ovale, ductus arteriosus

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7
Q

Ductus venosus

A

connects to umbilical vein to the IVC

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8
Q

Foramen ovale

A

opening in atrial septum, connecting RA to LA

Allows best oxygenated blood to enter LA->LV, ascending aorta, carotids

Membrane flap on LA side

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9
Q

Ductus arteriosus

A

connects pulmonary bifurcation to descending aorta

93% of RV output follows this path- other 7% goes to lungs

Patency maintained by PGE2 (produced by placenta)

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10
Q

What happens to PVR when baby is born?

A

It decreases as lungs physically expand and circulating oxygen is increases

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11
Q

What happens to SVR when baby is born?

A

It increases as cord is clamped and cut

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12
Q

Why does flow decrease when baby is born?

A

Due to decreased PVR

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13
Q

Why does amount of PGE2 circulating decrease when baby is born?

A

Increased lung metabolism

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14
Q

What happens to shunt when baby is born?

A

Becomes bidirectional then left to right

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15
Q

When does functional/physiological closure duct occur?

A

first few hours/ days

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16
Q

When does anatomical duct closure occur?

A

7-10 days

17
Q

What group of infants is patent ductus arteriosus common?

A

Preterm infants

  • can contribute to other preterm complications
  • treatment is wait and see, NSAIDs and surgery
18
Q

When is IV PGE2 used

A

To maintain duct latency in duct dependent circulation until an alternative shunt is established or definitive surgery is carried out

19
Q

When is normal adult type levels of PVR reached?

A

2-3 months

20
Q

Result of failure to of PVR to fall

A

Persistent pulmonary hypertension

  • likely in sick babies ie sepsis, cold stress
  • can be related to abnormalities like congenital diaphragmatic hernia
21
Q

What happens to shunts in PPHN?

A

They remain
right to left at PFO and PDA

Causes large difference between pre and post ductal pO2

Cardiovascular (14 decks)

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