Kiserud T
Seksjon for fostermedisin-Ultralydlaboratoriet Kvinneklinikken Haukeland Sykehus Postboks 1 5021 Bergen.
Tidsskr Nor Laegeforen. 2001 Jan 30;121(3):313-7.
Modern technology, especially ultrasound, has made foetal medicine a rapidly expanding field. The aim of the present review is to focus at the traditional knowledge of foetal circulation, which has recently been reassessed and expanded to serve our new patient, the human foetus.
Based on literature published mainly over the last 10 years, specific mechanisms of the foetal circulation are discussed, particularly the three foetal shunts and the placental circuit.
The foetal circulation has capacity to compensate for considerable cardiovascular abnormalities and to redistribute circulation to meet shortage in resources. The circulatory mechanisms described in animal foetuses also operate in the human foetus, but with notable differences. The ductus venosus shunts 20-30% of the umbilical blood in the human foetus compared to 50% in the foetal lamb. The foramen ovale receives less (18-34% of the combined cardiac output) and the lungs more blood (13-25%) in the human foetus than in the foetal lamb. The isthmus aortae represents a watershed area reflecting the redistribution of blood during increased peripheral impedance and hypoxemia.
The expanded knowledge in human foetal circulation promises a more differentiated evaluation than the Doppler examination of the umbilical and middle cerebral artery offers at the moment.
现代技术，尤其是超声技术，使胎儿医学成为一个迅速发展的领域。本综述的目的是聚焦于胎儿循环的传统知识，该知识最近已被重新评估并扩展，以服务于我们的新患者——人类胎儿。
基于主要在过去10年发表的文献，讨论了胎儿循环的具体机制，特别是三种胎儿分流和胎盘循环。
胎儿循环有能力补偿相当大的心血管异常，并重新分配循环以满足资源短缺。动物胎儿中描述的循环机制在人类胎儿中也起作用，但有显著差异。与胎儿羊羔中50%相比，人类胎儿中静脉导管分流20%-30%的脐血。与胎儿羊羔相比，人类胎儿中卵圆孔接受的血液较少（占心输出量总和的18%-34%），而肺部接受的血液较多（13%-25%）。主动脉峡部代表一个分水岭区域，反映了在周围阻抗增加和低氧血症期间血液的重新分配。
人类胎儿循环知识的扩展有望提供比目前脐动脉和大脑中动脉多普勒检查更具差异性的评估。
