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The Transition from Fetal to Postnatal Life: Normal and Abnormal Hearts

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Critical Care of Children with Heart Disease

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Abstract

At no other time in life does the human cardiovascular system undergo changes as profound as those changes that occur at birth. The circulation switches from one that is in parallel to one that is in series, systemic afterload increases suddenly, and pulmonary afterload decreases. The fetal shunts – the patent ductus arteriosus (PDA) and the patent foramen ovale (PFO) – close. The infant with a cardiovascular anomaly dependent on the parallel circulation and the fetal shunts will not survive the transition to stable postnatal life without intervention. This chapter will first review the prenatal hemodynamics and flow patterns in the normal and abnormal fetal heart. Second, it will describe the circulatory changes accompanying birth and explain the consequences of the extrauterine life to the neonate with cardiac anomalies.

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Authors and Affiliations

  1. University of Colorado Denver School of Medicine, Colorado Fetal Care Center and the Heart Institute, Children’s Hospital Colorado, Aurora, CO, USA

    Bettina F. Cuneo

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  1. Bettina F. Cuneo
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Correspondence to Bettina F. Cuneo .

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Editors and Affiliations

  1. Chief, Division of Cardiac Critical Care Medicine Executive Director, Telemedicine Co-director, Children’s National Heart Institute, Professor of Pediatrics, George Washington University School of Medicine, Children’s National Health System, Washington, DC, USA

    Ricardo A. Munoz

  2. Department of Pediatric Cardiothoracic Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Victor O. Morell

  3. Associate Medical Director, CHCO Heart Institute Head, Pediatric Cardiac Critical Care Program & Inpatient Services Director, Cardiac Intensive Care Unit Children’s Hospital Colorado, Tenured Professor of Pediatrics, Pediatric Cardiology and Intensive Care University of Colorado Denver, School of Medicine, Aurora, CO, USA

    Eduardo M. da Cruz

  4. Department of Pharmacy, Pediatric Critical Care, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Carol G. Vetterly

  5. Department of Pediatric Cardiothoracic Surgery, UPMC – Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Jose Pedro da Silva

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Cuneo, B.F. (2020). The Transition from Fetal to Postnatal Life: Normal and Abnormal Hearts. In: Munoz, R., Morell, V., da Cruz, E., Vetterly, C., da Silva, J. (eds) Critical Care of Children with Heart Disease . Springer, Cham. https://doi.org/10.1007/978-3-030-21870-6_1

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  • DOI: https://doi.org/10.1007/978-3-030-21870-6_1

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