The fetal circulation

@article{Kiserud2004TheFC,
  title={The fetal circulation},
  author={Torvid Kiserud and Ganesh Acharya},
  journal={Prenatal Diagnosis},
  year={2004},
  volume={24}
}
Accumulating data on the human fetal circulation shows the similarity to the experimental animal physiology, but with important differences. The human fetus seems to circulate less blood through the placenta, shunt less through the ductus venosus and foramen ovale, but direct more blood through the lungs than the fetal sheep. However, there are substantial individual variations and the pattern changes with gestational age. The normalised umbilical blood flow decreases with gestational age, and… 
Core Concepts: Fetal Cardiac Physiology
TLDR
The fetal myocardium and circulation differ from that of the adult in many important ways, and the fetus has unique methods to adapt to intrauterine stressors on the cardiovascular system.
Placental Gas Exchange and the Oxygen Supply to the Fetus.
TLDR
The oxygen supply of the fetus depends on the blood oxygen content and flow rate in the uterine and umbilical arteries and the diffusing capacity of the placenta and the underlying mechanisms are a current focus of research.
Clinical Significance of Ductus Venosus Waveform as Generated by Pressure-volume Changes in the Fetal Heart
TLDR
This review serves to improve the understanding of the mechanisms that regulate the blood flow redistribution between the fetal liver circulation and fetal heart and the clinical significance of the ductus venosus waveform as generated by pressure-volume changes in the fetal heart.
Simulation and Analysis of Umbilical Blood Flow using Markov-based Mathematical Model
TLDR
Simulation results show that the umbilical artery blood flow velocity waveform depends on gestation age, fetal heart rate, uterine contraction and placental insufficiency, and the Doppler indices calculated from simulation helps in predicting both maternal abnormalities at various degrees of the conductivity to the blood flow passage.
Multiscale modelling of the feto–placental vasculature
TLDR
A new anatomically based and multiscale approach to modelling the feto–placental circulation is presented, showing that normal asymmetry in shape does not affect placental efficiency, however, the size and number of small capillary vessels is predicted to have a large effect on feto-placenta resistance and flow heterogeneity.
Noninvasive determination of the fetal cardiac interatrial pressure gradients by Doppler ultrasonography: preliminary results
  • C. Gürses, O. Erol, B. Karadağ, Mete Çağlar
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2019
TLDR
The interatrial and ducto-umbilical pressure gradients can be measured noninvasively in order to follow the hemodynamic of the fetal circulatory system.
Evaluation of fetal cerebrovascular circulation and brain development: the role of ultrasound and Doppler.
  • S. Degani
  • Medicine
    Seminars in perinatology
  • 2009
TLDR
Anatomic and physiological considerations of cerebral vasculature in healthy and disease states are relevant in studying brain development and variations in fetal brain blood perfusion and the major role of ultrasound and Doppler modalities in the evaluation of fetal cerebrovascular circulation is enabled by implementation of these considerations.
Inverse Solution of the Fetal-Circulation Model Based on Ultrasound Doppler Measurements
TLDR
In conclusion, patient-specific modeling may provide a reliable estimate of the important hemodynamic indices of the fetal circulation which may be clinically relevant for the management of FGR pregnancies.
...
...

References

SHOWING 1-10 OF 113 REFERENCES
Distribution and regulation of blood flow in the fetal and neonatal lamb.
TLDR
The patterns of blood flow in the fetal liver and heart, and the preferential streaming of water flow, which favors distribution of oxygen to the brain and myocardium are described, are described.
The control of cardiovascular shunts in the fetal and perinatal period.
TLDR
Evidence is presented indicating that prostaglandin E2 and prostaglandsin I2 are natural relaxants, respectively, for the ductus arteriosus and theductus venosus, and both vascular shunts share the dependence on an endogenous cytochrome P-450 mechanism to develop their contractile tone.
Effects of Ductus Venosus Obstruction on Liver and Regional Blood Flows in the Fetal Lamb
TLDR
It is concluded that obstruction of the ductus venosus has no effect on regional blood flow distribution or oxygen delivery in normoxemic or hypoxemic animals and is not crucial in regulating umbilical venous return to the central fetal circulation.
Distribution of the circulation in the normal and asphyxiated fetal primate.
Hemodynamics of the ductus venosus.
  • T. Kiserud
  • Medicine, Biology
    European journal of obstetrics, gynecology, and reproductive biology
  • 1999
Regulation of blood flow through the ductus venosus.
TLDR
The purposes of this review are to summarize the data currently available on the regulation of ductus venosus blood flow in fetal and neonatal life and to identify those factors that affect ductus Venosus closure after birth.
The control of blood flow to the placenta
TLDR
Recent evidence points to an important role for altered vascular structure in growth‐retarded pregnancies, and nitric oxide is now considered to contribute to tonic reduction in vascular resistance.
Studies on the Circulation of the Previable Human Fetus
TLDR
The circulation was studied in 33 previable human fetuses delivered by hysterotomy, while the placenta was still attached, and there was a fairly uniform decrease in proportion of CO distributed to theplacenta, probably owing to umbilical vessel constriction.
Quantitative Assessment of Circulatory Changes in the Fetal Aortic Isthmus During Progressive Increase of Resistance to Umbilical Blood Flow
TLDR
Variations in Doppler blood flow velocity waveforms and integrals of the aortic isthmus can be used as a sensitive indicator of the state of the umbilical circulation.
Obstruction of ductus venosus stimulates cell proliferation in organs of fetal sheep.
TLDR
It is concluded that increases of hepatic blood flow stimulate cell proliferation in major organs of the ovine fetus.
...
...