After the birth of the child Adaptation processes for postnatal life are performed. During this period, placental blood flow stops, the gas exchange function moves to the lung, and fetal communications are closed. Small and large circulation of blood circulation becomes consistent. The resistance of the pulmonary vessels is progressively reduced due to their disclosure, and in the arterial line - it increases (due to the loss of placenta with low resistance).

After the first breath and the beginning of the pulmonary ventilation pulmonary blood flow increases sharply, redistributed cardiac ejectionThe load on the ventricles is changing. The whole stream of blood from the lungs is now returning to the left ventricle, significantly exceeding the volume in which it fell into it intrauterine; Immediately after birth, the left ventricle increases its release of 3-6 times more than the right ventricle. This is accompanied by an almost two-time increase in oxygen consumption by the body and a maximum heart rate per kilogram of a child's body mass.

By 6-8 weeks heart intensity significantly decreases. When calculating the cardiac output by 1 m2 of the body surface, the shock index (19 ± 5 ml / m2) and the heart rate (2.6 + 0.7 l / min / m2) in children of the first 2 months. It is reliably lower than in children older than 2 months. (24.5 ± 5 ml / m2 and 3.2 ± 0.7 l / min / m2 on average, p

After birth Normal hemodynamic modes of ventricular operation - right, injected blood in pulmonary vessels with relatively low resistance, and left blood circulation in a large circulatory circle with high vascular resistance, which affects the acceleration time (Wu) and expulsion time (VI) of ventricles

Final formal work parameters The right and left departments of the heart are shown in the figure. Normally, real pressure in the right ventricle and pulmonary artery It is 20-30% of the system pressure, saturation in the right-hand heart departments ranges from 65 to 80%, in the left - from 95 to 98%. Newborn or sedied children it may be lower.

Perestroika blood circulation It affects the morphological characteristics of the right and left ventricles, which undergo different transformation. By the end of the first year of life, the thickness of the left ventricular wall becomes almost two times more than the right, and its cavity practically does not change (Fig. 1-9). For the right ventricle, the dynamics of these indicators is the opposite: the wall thickness compared to the moment of birth remains the same, and the cavity increases twice.

General pulmonary resistance in the newborn.

General pulmonary resistance in the newborn (OLS) In the first 24 hours after birth, it decreases to -70% compared with the initial, but the pressure in the pulmonary artery is still at the level of 60-85% of the systemic. Its gradual normalization occurs to 14 days, and can be delayed to 1.5 months. As for the morphological postnatal restructuring of pulmonary vessels, it ends to 2-3 months.

In the process fast decline Ols An important role is played by oxygen and a number of vasoactive substances produced in the process of childbirth. In animal experiments, it was proved that the low P02 in the pulmonary artery in the intrauterine period supports the constriction of pulmonary vessels and low blood flow, and its increase is accompanied by an increase in pulmonary blood flow. The resistance of pulmonary vessels also affect the products of the metabolism of arachidonic acid, the most important of which are prostaglandins (PGE, PGD) and Prostaziklin (PGI2).

To improving products The latter will stretch the lungs or their mechanical stimulation, bradykinin and angiotensin-n. In addition, there is a degranulation of fat cells released by histamine and PGD, which in newborns cause a decrease in pressure and resistance in pulmonary vessels. Interestingly, histamine and PGD subsequently act otherwise and in adults cause vasoconstriction.

In addition to functional relaxation wall of pulmonary vessels Her structural changes occur. Reducing the resistance of the lungs due to the physiological refinement of the medial layer of pulmonary arterioles continues up to 8 weeks of life. The decline process of OLS can last in subsequent years due to an increase in the number of functioning pulmonary alveoli and the associated vessels.

The main differences of hemodynamics in the fetus are that it has functions:

• blood circulation through the placenta;
• low-infinted pulmonary blood flow;
• additional blood flow through the oval window and arterial dashing.

The placenta is the main source of nutrients, in its blood contains about 70% oxygen. Normally, as the fetus develops, the placenta increases its respiratory surface, and hemoglobin acquires a greater ability to bind oxygen.

The oval window is located in the interpresent part of the partition, through it a part of the blood from the placenta goes to the left heart chambers into the lungs, which do not function. This blood stream nourishes the neck, head and spinal cord. After childbirth, the need for shunting disappears, and the hole is first closed, and then completely overcomes by the end of the year.

Botals duct connects the main artery of the lungs and aorta. The main load in the fetus falls on the right ventricle (placental and its own blood comes into it), so pulmonary artery takes a large amount of blood and resets it through the duct into the aorta. Normally, it closes on the first day.

And here the transposition of the main vessels in the kids.

Features of the blood circulation of the newborn

The main hemodynamic differences after the birth of the baby are associated with the beginning of the pulmonary breathing and the redistribution of the load in the heart - from the right to the left departments.

Changes in circles of blood circulation

After the first inspire, the bloodstream in the lung vessels increases 5 - 7 times and about the same amount of the resistance of the arteries and veins in them. Since the volume of blood flow in the left atrium increases, and in the lower hollow vein decreases, the pressure between the atrialists changes - in the left becomes higher. Under the influence of these factors, the flap of the oval window covers the hole and stops the movement of the blood.

Most children will continue to complete the windows connective tissueWhat leads to its complete disappearance, but sometimes it happens only partially, or the hole does not overlap. Then, with a strong outline (crying, cry, cough), blood reset is resumed.

Aortic duct spasm occurs in the first hours after birth, under the influence of the increase in oxygen pressure in the blood. If the breath of the newborn for some reason weakens, then the walls of the vessel are repeated again. Complete overgrown with him at the end of 2 months of life.

Thus, the infant blood circulation system acquires the features of an adult due to the following changes:

• termination of placental blood flow after cord shift;
• disconnecting the main messages - Botallov duct, oval windows;
• golders guide blood in different circles of blood circulation;
• turning on the breath through the light and expansion of the vessels in them;
• increasing oxygen need;
• strengthening blood emissions;
• an increase in blood pressure.

Fetal transient blood circulation

The hemodynamic type of blood flow, which was in the fetus, is called fetal. It functions for several hours after birth. At this time, insignificant blood flow is preserved through the oval window and arterial duct. An interesting feature It is the bilateral passage of blood, synchronized with the phases of the cardiac cycle.

These partial communications between the heap departments are designed to reduce the load on myocardium and lung vessels, they enable the child to adapt to a new type of blood circulation. The peculiarities of the transition period is the possibility of such symptoms:

• the appearance of fingertips, lip, nasolabial triangle, which increase when crying or physical infant activity;
• noise over the heart area at the beginning of systole or before the end of the reduction of ventricles.

What is especially the blood circulation at the embryo?

Binds the embryo with the mother of the channel, according to which the nutrients are supplied, called the umbilical. Inside this channel contains one vein and two artery. Deoxygenated blood Fills the artery by passing through the umbilical ring.

Entering the placenta, it is enriched with the necessary nutritional elements for the fetus, oxygen saturation occurs, after which it goes back to the embryo. All this happens inside the umbilical vein, which flows into the liver and is divided into it within 2 branches. This blood is called arterial.

The structure of the placenta

One of the branches in the liver enters the region of the lower hollow vein, while the second is branched out of it and is divided into small vessels. That is how the hollow vein is saturated with blood, where it is mixed with blood, which comes from other body departments.

Absolutely all blood flow moves to the right atrium. The hole, located at the bottom of the vein, gives blood to the left side of the generated heart.

In addition to the listed uniqueness of the blood circulation of the child, you need to highlight the following:

• The function of the lungs is completely on the placenta,
• At first, blood leaves from the upper hollow vein, and only then fills the rest of the heart,
• If the embryo does not have respiration, then small lung capillaries create pressure on the movement of blood, which in the artery of the lung is unchanged, and in the aorta falls relatively to it,
• Moving from the left ventricle and artery, the amount of emission is generated by the heart of the blood, and it is 220 ml / kg / min.

When blood is drawn in the embryo, then only 65% \u200b\u200bis saturated in the placenta, the remaining 35% are concentrated in the organs and tissues of the future child.

Blood circulation disorders: species, diagnostics

To prevent the development of anomalies of the heart or vessels of the future child, a pregnant woman needs to regularly visit the gynecologist. Experts identify the following forms of breeding of the fruit:

• placental;
• fetoplacentar;
• saint-placental.

Attention!

Any of these disorders may entail serious deviations in the development of the fetus, up to the formation of severe industries, fatal outcome. The pathological state of the placenta reduces its barrier function and the degree of protection against attaching a bacterial or viral infection.

To diagnose violations, the doctor uses ultrasound procedure, Dopplerometry. They help calculate the speed of blood flow and the degree of vessel resistance in the mother-placental-fruit system. During the survey, the specialist estimates the thickness of the placenta, the number of accumulating water, identifies the signs of the suffered infectious disease.

Blood impairment has three stages:

1. Indicators are slightly deviated from the norm. Bloodstock in the system is not broken.
2. There is a more significant deviation of the indicators from normal values. Bloodstock is disturbed at all stages.
3. Critical violation of fetal blood flow indicators.

What is the unique blood circulation after birth?

The full-fledged child has, after he is born, there are a number of physiological changes in the body, during which its vessel system begins to function independently. After cut and dressing the Karta navel, the exchange between the mother and the child stops.

The newborn is beginning to function lightly, and working alveoli reduce the pressure in a small circle of circulation almost 5 times. As a result, there is no need for arterial duct.

When blood circulation is started through the lungs, substances that contribute to the expansion of the vessels are released. Arterial pressure grows, and become more than in the artery of the lung.

From the first breath, changes begin, leading to the formation of a full-fledged human body, the oval window occurs, the bypass vessels are overlap, coming to a full-fledged system of functioning.

Blood circulation of the fetus: scheme and description

At the end of the fifth week, primary, or yolk, system begins to work. It includes arteries and veins, which are called umbilical mesenteric. This type of blood circulation refers to rudimentary forms. As the embryo development and improving its systems, it loses its meaning.

Circulation scheme in the fetal body:

1. From the placenta, the blood enters the umbilical vein, from there it is sent to the liver. Most of the blood is discharged into the lower hollow vein through the venous duct. Before the liver gate, the bubble vein merges with a gorgeous, which is still developed enough.
2. After passing the venous hepatic system, the blood enters the lower hollow vein, mixed with a stream, which is reset through venous duct. The next paragraph is the right atrium, which gets blood from the upper hollow vein, assembled from the whole organism.
3. Features of the structure of the heart of the fetus do not allow blood completely mixed. From the upper floor of the vein, the blood enters the right ventricle, and then into the pulmonary artery. From the bottom hollow vein, it hits an oval hole in the left atrium.
4. Part of the blood from La penetrates the lungs for the system, which do not work yet, and then reset in LP. The rest of the flow through the OPA falls into the downstream of the aorta, where to spread from the bottom half of the body.
5. In the LD, there is a mixing of two blood flows. Oxygenated blood enters the upstream of the aorta, from where the brain is delivered, the entire upper half of the body.
6. Blood in which there is no oxygen, through an umbilical arteries is delivered to the chorion navigas.

Attention!

This creates a circle of fruit blood circulation. Features of heart structures, fetal blood circulation ensure the developing fruit with full nutrition and saturate its oxygen tissue.

Structure blood system The child provides the necessary gas exchange. This is necessary due to the lack of pulmonary respiration. The blood circulation of the fetus is different from such an adult:

• carbon dioxide, decay products are removed from the body through the navel artery (this is the shortest way);
• part of the blood passes through a small circle, but its parameters do not change;
• the main blood circulates by big circlethat provides an oval window, arterial, venous ducts;
• in the body of the fetus, a mixture of venous and arterial blood;
• pressure in Aorte and La Low.

What is fetal blood circulation

This is another name of placental blood circulation. It has some features:

1. All embryonic organs are necessary for life support. Oxygen-enriched blood comes to organs from the upper aorta.
2. Right and left cordial fetal cameras have a connection through large vessels. The first carries out blood circulation using an oval window, which is located in the interpidential partition. Through the second vessel, blood flow is carried out through a hole that shares the pulmonary artery and aorta.
3. Blood circulation by a large circulation of blood circulation takes more time than in small.
4. Right and left ventricles are reduced simultaneously.
5. Pressure in the right of atrium exceeds such in the left.
6. Blood release with right ventricle for 2/3 more, if compared with general heart emissions.
7. Aortic and blood pressure have the same values \u200b\u200b- 70/45 mm Hg. Art.
8. Fetal blood flow has high speed.

The main blood circulation of the fetus is the chorial, represented by vessels of umbilical cord. Horial (placental) blood circulation begins to ensure the gas exchange of the fetus since the end of the 3rd - the beginning of the 4th week of intrauterine development. The capillary network of choriy villion placenta merges into the main trunk - the umbilical vein, passing in the composition of the umbilical cord and the blood oxygenated and rich nutrients. In the body of the fetus, the umbrellas are sent to the liver and before entering the liver through a wide and short venous (arancium) duct gives a significant part of the blood into the lower hollow vein, and then combined with a relatively poorly developed carrier vein. Having passed through the liver, this blood enters the lower hollow vein on the system of returnable hepatic veins. Blood mixed in the lower hollow vein enters the right atrium. It also comes here and purely venous blood from the upper hollow vein, leaking from the cranial areas of the body. At the same time, the structure of this part of the heart of the fetus is such that here the complete mixing of two blood flows does not occur.

The blood entered into the right atrium from the lower hollow vein is mostly in a widely gaping oval window and then into the left atrium, where it is mixed with a small amount of venous blood passed through the lungs, and enters the aorta to the place of arterial duct, providing better oxygenation and trophy of the brain, coronary vessels and the entire upper half of the body. All bodies of the fetus receive only mixed blood.

Blood circulation of a newborn.

At birth, the blood circulation is restructuring, which is solely acute. The most significant moments are considered as follows:

1) termination of placental blood circulation;

2) the closure of the main fetal vascular communications (venous and arterial duct, oval windows);

3) switching the pumps of the right and left heart from parallel to working in consistently included;

4) the inclusion in the full vascular channel of a small circle of blood circulation with its high resistance and a tendency to vasoconstriction;

5) an increase in oxygen need, cardiac output and systemic vascular pressure.

Immediately after the first breath, under the influence of partial oxygen pressure, spasm of arterial duct occurs. However, the duct, functionally closed after the first respiratory movements, can reveal again if the respiratory efficiency is violated. Anatomical overlap of arterial duct occurs later (in 90% of children to the 2nd month of life). The small (pulmonary) and large circles of blood circulation are beginning to function.

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  Circulation fruit and newborn. Basic circulatory fruit is the chorial, represented by vessels of umbilical cord. Horial (placental) circulation Begins to provide gas exchange fruit From the end of the 3rd - the beginning of the 4th week ...


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  Circulation fruit and newborn. Basic circulatory fruit


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  Circulation fruit and newborn. Basic circulatory fruit is the chorial, represented by vessels of umbilical cord. Chorial.


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  Circulation fruit and newborn. Basic circulatory fruit is the chorial, represented by vessels of umbilical cord.
  W. fruit There is a permanent increase in the number of erythrocytes, the content of hemoglobin, the number of leiko ... more.


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  After discharge newborn From the maternity hospital, information on the phone is transferred to the Children's Poly. Antenatal guard fruit.
  2) obstetric and gynecological (including complications of pregnancy and condition fruit)


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  newborn ranges from 46 to 52 cm or more, up to an average of 50 cm.
  Dimensions of the body fruit The following: 1) Handbaken size (brachial belt diameter) - 12 cm, the circle of the shoulder belt - 35 cm


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  Length (height) of a mature docking newborn ranges from 46 to 52 cm or more, making up.
  When examining the feminine, history, physical inspection, laboratory test data and state assessment fruit.


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  Antenatal guard fruit.
  First patronage K. newborn. After discharge newborn From the maternity hospital, information on the phone is transferred to the children's clinic, where in the journal visits newborn Record F. I. O. Mother, address and date of birth ...


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  W. newborn The bone marrow mass is 1.4% of the body weight (40 g), in an adult man - 3000 g. In terms of 9-12 weeks, Megaloblasts contain primitive hemoglobin, which is replaced
  Saturation of the body fruit Iron occurs transplacentar.


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  Last period (the third period of childbirth) begins from the moment of birth fruit and Ends born.
  The fever is transferred to the labor hall, where the equipment, tools, sterile material and underwear should be ready for the primary toilet. newborn.

Also found Page: 10

For the embryo, blood circulation is the most important function, because it is through it that the fruit is saturated with nutrients.

About two weeks, after conception is formed the cardiovascular system fetusand since then, it needs a constant influx of beneficial substances.

Also need to carefully follow the health of the future mother, because frequent diseases Let us lead to the deviations in the development of the embryo. That is why during pregnancy, it is recommended to constantly observe the doctor.

How is the formation of a future child?

The formation of the future child occurs in the stages, each of which develops any system or body.

The table below shows the stages of the development of the future child:

What is especially the blood circulation at the embryo?

Binds the embryo with the mother of the channel, according to which the nutrients are supplied, called the umbilical. Inside this channel contains one vein and two artery. Venous blood fills the artery by passing through the umbilical ring.

Entering the placenta, it is enriched with the necessary nutritional elements for the fetus, oxygen saturation occurs, after which it goes back to the embryo. All this happens inside the umbilical vein, which flows into the liver and is divided into it within 2 branches. This blood is called arterial.

One of the branches in the liver enters the region of the lower hollow vein, while the second is branched out of it and is divided into small vessels. That is how the hollow vein is saturated with blood, where it is mixed with blood, which comes from other body departments.

Absolutely all blood flow moves to the right atrium. The hole, located at the bottom of the vein, gives blood to the left side of the generated heart.

In addition to the listed uniqueness of the blood circulation of the child, you need to highlight the following:

• The function of the lungs is completely on the placenta;
• First, the blood leaves the upper hollow vein, and only then fills the rest of the heart;
• If the embryo does not have breathing, then small lung capillaries create pressure on the movement of blood, which in the artery of the lung is unchanged, and in the aorta falls relatively to it;
• Moving from the left ventricle and artery, the amount of emission is generated by the heart of the blood, and it is 220 ml / kg / min.

What is fetal blood circulation?

The name of the fetal blood circulation is also inherent in placental blood circulation.

It also contains its features:

• Absolutely all the embryo bodies are necessary for life (brain, liver and heart) and feed on blood. It comes from the upper aorta, enriched with oxygen more than the remaining body zones;
• There is a connection to the right and left half of the heart. This connection takes place on a large vessels. There are only two of them. One of them is responsible for blood circulation, using an oval window, in a partition between atrialists. And the second vessel produces an appeal with the help of a hole separating the aorta and the artery of the lung;
• It is at the expense of these two vessels, the time of movement of the blood flux by a large circle of circulation more than in a small circle;
• At the same time there is a reduction in the right and left ventricles;
• The right ventricle gives more blood flow by two-thirds, compared with the overall release. At this time, the system stores a large load pressure;
• With such blood circulation, the same pressure is maintained in artery and aorta, which is usually 70/45 mm.rt.;
• It has a big pressure right atrium than left.

Fast speed - normal indicator Fetal blood circulation.

What is the unique blood circulation after birth?

The full-fledged child has, after he is born, there are a number of physiological changes in the body, during which its vessel system begins to function independently. After cut and dressing the Karta navel, the exchange between the mother and the child stops.

The newborn is beginning to function lightly, and working alveoli reduce the pressure in a small circle of circulation almost 5 times. As a result, there is no need for arterial duct.

When blood circulation is started through the lungs, substances that contribute to the expansion of the vessels are released. Blood pressure grows, and become more than in the artery of the lung.

From the first breath, changes begin, leading to the formation of a full-fledged human body, the oval window occurs, the bypass vessels are overlap, coming to a full-fledged system of functioning.

Deviations of blood circulation of the fruit

To prevent any violations in the development of the future child, a pregnant girl should be constantly monitored from a qualified physician. As The pathological processes in the body of the future mother affect the deviations in the development of the fetus.

An extremely necessary examination of an additional circulation of blood circulation is imperative, since it can lead to severe complications, miscarriages and the death of the fetus.

Doctors share three forms for which disorders of blood circulation of the fetus are separated:

• Placentamentar (PN). Is an clinical syndromewhich occurs structural and functional changes of the placenta, which is reflected in the state and normal development of the fetus;
• Fetoplacentar (FPN). Is the most common complication of pregnancy;
• Saint-placental.

She also protects against fetal viral infections, bacteria, and diseases of diseases. The blood circulation failure will entail pathological changes in the embryo.

Diagnosis of circulatory failures

Determining problems with blood flow, and any damage to the future child, occurs with the help of an ultrasound (ultrasound study), or dopplerometry (one of the types of ultrasound diagnostics, helping to determine the intensity of blood circulation in the vessels of the uterus and umbilical cord).

When the examination passes, the data is displayed on the monitor and the doctor monitors the manifestation of factors that can be stated on circulatory impairment.

Among them:

• A thinner placenta;
• The presence of diseases of infectious origin;
• Assessment of the state of the accumulative water.

When conducting dopplerometry, the doctor can diagnose three stages of blood circulation stages:

Research ultrasound is safe method Surveys for future mothers on any time of pregnancy. Additionally, the blood studies of the future mother can be assigned.

Consequences of circulatory failures

In case of a failure in a single system of functioning of blood from the mother to the placenta and germin, placental insufficiency appears. It happens because The placenta is the main supplier of oxygen and nutrients for the embryo, And unites two main systems directly the future mother and the embryo.

Any deviations in the organism of the mother are entailing the embryo blood circulation failures.

Doctors are always diagnosed with the degree of blood circulation. In the event of the diagnosis of the 3rd degree, urgent measures are used in the form of therapy or surgical intervention. According to statistics about 25% of pregnant women undergo placenta pathology.

Blooding of the fetus. Most of the information on the blood circulation of the fetus was obtained in experiments on calves and monkeys. Despite the existence of certain species differences, it can be assumed that the development of the blood circulation system in the fetus of a person and its changes after the birth of a child are similar to those detected in the experiment. The oxygenated blood comes from the placenta into the body of the fetus according to the umbilical vein at an average rate of 175 ml / kg at a pressure of about 12 mm RT. Art. and ROA -Ocolo 30 mm Hg. Art.

Approximately 50% of the entire blood of the umbilical vein passes through the liver and through the venous duct enters the lower hollow vein, in which it is mixed with the rest of the blood flowing from the caudal part of the body. Next, through the lower hollow vein, the blood enters the right atrium. Most of it then passes through the oval window in the left atrium, then in the left ventricle and in the aorta. The blood coming to the coronary and brain arteries of the upper limbs to the arteries is different high levels PO2\u003e rather than blood flowing to the rest of the parts of the body, except liver. Significantly less oxygenated blood from the upper floor of the vein comes through a three-rolled valve into the right ventricle, and from it to the barrel of the pulmonary artery.

The tone of different intensity shows the change in blood saturation with oxygen. The arrows indicate the direction of blood flow. Most of the blood of the umbilical vein enters the venous duct and passes through the liver. This relatively highlyoxygenized blood through an oval hole enters the left stapers of the heart, of which - in the vessels of the head and the upper half of the body. From the upper hollow vein, blood through the right heart departments enters the pulmonary artery and arterial duct, and then in the placenta, organs and vessels of the lower half of the body. Dotted lines indicate blood flow in the lungs. The flow of blood from the ascending aorta in its experiencing is also limited.

22 mm RT. Art. After passing through the lungs, it comes through the arterial duct into the downward aorta, from where it is distributed between the caudal end and the placenta. Effective cardiac release of the fetus, which is the sum of left-hearted emissions and a minute volume of blood flowing through arterial duct, reaches 220 ml. About 65% of this blood returns to the placenta, and 35% of the remaining perfusers the organs and tissues of the newborn.

Since the ventricles of the newborn are reduced synchronously, and not consistently, the distribution of blood pushed by them is determined by the overall blood flow and the resistance of the corresponding vessels, which in turn depends on the existence of a wide arterial duct that equalizes the pressure in the aorta and the pulmonary artery. Due to the high resistance of the blood vessels of a small circle, blood from the pulmonary artery is not in the lungs, but in the arterial duct and further into the downward aorta. The mechanisms leading to the spasome of pulmonary arterpol have not yet been studied. Both alveoli filled with liquid content and compressed and winding vessels of the micro circulatory stream of unreacted light fetus are a significant obstacle to blood flow. It is generally recognized that the resistance of the vessels of a small circle depends mainly from PC\u003e 2 blood perfusing the lungs. If its pressure in the arterial blood of a small circle exceeds 35 mm Hg. Art., The resistance of the vessels of a small circle decreases and increases pulmonary blood flow.