Persistent fetal circulation is a condition caused by a failure in the systemic circulation

Systemic circulation

Systemic circulation is the part of the cardiovascular system which carries oxygenated blood away from the heart to the body, and returns deoxygenated blood back to the heart. This physiologic theory of circulation was first described by William Harvey...

 and pulmonary circulation

Pulmonary circulation

Pulmonary circulation is the half portion of the cardiovascular system which carries Oxygen-depleted Blood away from the heart, to the Lungs, and returns oxygenated blood back to the heart. Encyclopedic description and discovery of the pulmonary circulation is widely attributed to Doctor Ibn...

 to convert from the antenatal circulation pattern to the "normal" pattern.

In a fetus, there is high pulmonary vascular resistance and low pulmonary blood flow as the fetus does not use the lungs for oxygen transfer. Once the baby is born, the lungs are needed for oxygen transfer and need high blood flow which is encouraged by low pulmonary vascular resistance.

It can be associated with pulmonary hypertension

Pulmonary hypertension

In medicine, pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion...

. Because of this, the condition is also known as "persistent pulmonary hypertension of the newborn".

Normal vascular anatomy with functional vasoconstriction

Good prognosis as reversible

Causes - hypoxia

Hypoxia (medical)

Hypoxia, or hypoxiation, is a pathological condition in which the body as a whole or a region of the body is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise...

, meconium

Meconium

Meconium is the earliest stools of an infant. Unlike later feces, meconium is composed of materials ingested during the time the infant spends in the uterus: intestinal epithelial cells, lanugo, mucus, amniotic fluid, bile, and water. Meconium is almost sterile, unlike later feces, is viscous and...

 aspiration, respiratory distress syndrome

Decreased diameter of pulmonary vessels with hypertrophy of vessel walls

Poor prognosis as fixed abnormality

Causes - post term pregnancy, placental insufficiency, NSAID use by mother

Decreased size of pulmonary vascular bed

Poor prognosis as fixed abnormality

Causes - space occupying lesions i.e. pleural effusions, diaphragmatic hernia

Functional obstruction of pulmonary blood flow

Good prognosis if reversible

Causes - polycythemia

Polycythemia

Polycythemia is a disease state in which the proportion of blood volume that is occupied by red blood cells increases...

, hyperfibrinogenemia

Treatment

Treatment aims to increase the amount of oxygen in the blood and reverse any causes of hypoxia.

• oxygen therapy
• mechanical ventilation
• NO Inhalation
• Prostaglandins (intravenous)

External links

• http://www.kumc.edu/instruction/medicine/pedcard/cardiology/pedcardio/pfcdiagram.gif