PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3071046

[Recent physiologic and pathophysiologic findings on fetal circulation].

H Schwartze
View original source ↗Export metadata ↓

Abstract

Venous return of the fetal circulation consists of 70% blood from the lower body and of 30% blood from the upper body. Blood of the left V. hepatica contains more oxygen than that of the right hepatic vein. This rather well oxygenated blood from the left hepatic lobe joins the blood of the Ductus venosus, carrying high concentrations of O2 and glucose predominantly to the left ventricle, Aorta ascendens, and Truncus brachiocephalicus. Less oxygen saturated blood of the right hepatic lobe together with the venous return of V. cava superior reaches the right ventricle via the tricuspid valve, then the Ductus arteriosus and Aorta descendens. The hepatic microcirculation seems to be of importance for regulations of the fetal venous return. However, the supply of organs with oxygen and nutrients is mainly dependent on regional vascular resistances.

Explore related subjects

Ductus Arteriosus, PatentFemaleHumansMaternal-Fetal ExchangeOxygenPregnancyEnglish AbstractJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

H Schwartze. 1988. [Recent physiologic and pathophysiologic findings on fetal circulation].. https://pubmed.ncbi.nlm.nih.gov/3071046/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Patent ductus arteriosus ligation in premature infants: who really benefits, and at what cost?

PURPOSE: Patent ductus arteriosus (PDA) ligation in premature infants has been shown to have low surgical morbidity and mortality. Ligation goals include prompt improvement in cardiorespiratory failure, with rapid wean from mechanical ventilation; less risk of prolonged mechanical ventilation and subsequent chronic lung disease (CLD); and survival to discharge. This study was designed to examine true morbidity after ligation and elucidate which preoperative factors might predict favorable outcomes. METHODS: Institutional review board-approved retrospective review of 197 infants less than 38 weeks of gestational age (GA), undergoing PDA ligation via thoracotomy between January 1, 1992, and January 1, 2004. Chronic lung disease defined as need for supplemental oxygen at 36 weeks corrected GA. Student t and chi2 tests were used. RESULTS: Mean GA was 27 weeks (range, 23-35 weeks), birth weight was 957 g (range, 440-3170 g); infants underwent ligation at 16 days of life (range, 1-132 days). Duration of surgery was 50.5 minutes (range, 13-150 minutes). Mean postoperative times were 27 days to extubation, 60 days to wean from supplemental oxygen, and 84 days to discharge. Early extubation (within 10 days of ligation) occurred in only 54 patients (30%). Only 44 (22%) survived to discharge without CLD. Forty patients (20%) died, with respiratory failure the most common cause (70%). In general, early extubation, survival without CLD and survival to discharge were associated with greater GA and birth weight, higher Apgar scores, greater age and weight at surgery, no preoperative intraventricular hemorrhage, lack of ventilator dependence, and lower ventilator settings (P < .05). Preoperative amount and duration of indomethacin use, chest x-ray findings, and echocardiographic assessment of ductus size did not predict favorable outcomes (all P > .05). CONCLUSIONS: Most premature infants currently undergoing PDA ligation at our institution do not experience the anticipated rapid improvements in cardiorespiratory status and go on to develop CLD. Few preoperative variables (including radiographic and echocardiographic assessments) definitively predict outcomes.

Ductus Arteriosus, Patent↗
PubMed2006

Sequelae of recurrent laryngeal nerve injury after patent ductus arteriosus ligation.

OBJECTIVES: To prospectively study the clinical course of neonates with vocal cord paralysis (VCP) after patent ductus arteriosus (PDA) ligation. METHODS: A prospective cohort study of all premature infants undergoing PDA ligation from March 2001 to February 2004. Flexible laryngoscopy was performed after extubation to assess vocal cord function. Data regarding patient characteristics, operative findings, post-operative endoscopic findings, and the subsequent clinical course were collected. RESULTS: One hundred patients were enrolled. Flexible laryngoscopy was performed on 61 patients. Median birth weight was 740 g, gestational age 25 weeks, and age at operation 23 days. Flexible laryngoscopy was performed at an average of 8 days after extubation. Seven cases of vocal cord paralysis were identified. Two had stridor and feeding difficulty requiring nasogastric feeding. Five of the seven had an average follow-up of 9 months after surgery. At last follow-up, endoscopically satisfactory compensation by the normal vocal cord was observed in all five patients. No patient had feeding problems. CONCLUSIONS: The majority of infants who can be successfully extubated after PDA ligation tend to be asymptomatic despite vocal cord paralysis. Compensation appears to occur rapidly, and patients generally have no *long-term problems with the airway or feeding.

Ductus Arteriosus, Patent↗