Fetal Circulation

High-Yield Summary

  • Placenta exchanges gas/nutrients/waste by diffusion without mixing maternal and fetal blood; also an immune barrier and endocrine organ.
  • Fetal hemoglobin (HbF) has higher O₂ affinity than adult hemoglobin, extracting oxygen efficiently from maternal blood.
  • Umbilical arteries carry deoxygenated blood away from fetus (toward placenta); umbilical vein carries oxygenated blood to the fetus — reverse of typical artery/vein oxygenation.
  • 3 shunts bypass non-functional fetal lungs/liver: foramen ovale (RA→LA, bypasses lungs), ductus arteriosus (pulmonary artery→aorta, bypasses lungs), ductus venosus (umbilical vein→IVC, bypasses liver).

Key Terms

Fetal hemoglobin (HbF)
Higher O₂ affinity than adult hemoglobin; pulls oxygen across the placenta more effectively.
Foramen ovale
Opening between right and left atria; shunts blood past the lungs.
Ductus arteriosus
Connects pulmonary artery to aorta; reroutes blood past the lungs.
Ductus venosus
Lets oxygenated umbilical vein blood bypass the liver, flowing into the inferior vena cava.

Umbilical Vessels

VesselCarries
Umbilical arteries (2)Deoxygenated blood, fetus → placenta
Umbilical vein (1)Oxygenated blood, placenta → fetus

The Three Fetal Shunts

ShuntPath / Bypasses
Foramen ovaleRight atrium → left atrium; bypasses lungs
Ductus arteriosusPulmonary artery → aorta; bypasses lungs
Ductus venosusUmbilical vein → inferior vena cava; bypasses liver

Common MCAT Trap

  • Umbilical vessels are named by direction (to/from fetus), NOT by oxygenation — umbilical vein carries oxygenated blood, umbilical arteries carry deoxygenated blood (opposite of systemic convention).
  • Two shunts bypass the lungs (foramen ovale, ductus arteriosus) but only one bypasses the liver (ductus venosus) — don't mix up which organ each one skips.

Quick Recall

Which fetal shunt allows blood to bypass the liver?

Why does the umbilical vein carry oxygenated blood, unlike typical veins?

Why does fetal hemoglobin help the fetus, functionally?