Circulatory and Metabolic Adjustments of the Fetus at Birth

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Abstract
This brief excursion into the realm of fetal and neonatal circulations provides an integrated picture of the adjustments that occur at birth. At the same time it also points out the marked deficiencies in our knowledge of many areas pertaining to this important biological field. The recent advances in medical technology and instrumentation have certainly permitted the collection of data which were previously not available. Through simultaneous monitoring of instantaneous flow-pressure parameters from various vascular areas during the fetal and neonatal life, it has been possible to delineate the magnitude of the right ventricular dominance in the fetus and the time of its subsidence in favor of the left ventricular dominance after birth. Information has also been obtained regarding the magnitude of the fetal cardiac output and its relation to the vascular shunts, and to the low oxygen content of the fetal blood. But, despite these advances, there are still many facets of fetal and neonatal biology which require intensive investigation. We know very little about such important subjects as the control of cerebral circulation and its relation to the onset of breathing, the regional distribution of cardiac output, the control of pulmonary circulation, the dynamics of placental circulation and its role in the transport of substances between mother and fetus.