PT - JOURNAL ARTICLE AU - A M Rudolph TI - Congenital cardiovascular malformations and the fetal circulation AID - 10.1136/adc.2007.128777 DP - 2010 Mar 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - F132--F136 VI - 95 IP - 2 4099 - http://fn.bmj.com/content/95/2/F132.short 4100 - http://fn.bmj.com/content/95/2/F132.full SO - Arch Dis Child Fetal Neonatal Ed2010 Mar 01; 95 AB - After birth, gas exchange is achieved in the lung, whereas prenatally it occurs in the placenta. This is associated with differences in blood flow patterns in the fetus as compared with the postnatal circulation. Congenital cardiovascular malformations are associated with haemodynamic changes in the fetus, which differ from those occurring postnatally. Obstruction to cardiac outflow may alter myocardial development, resulting in progressive ventricular hypoplasia. Alteration of oxygen content may profoundly influence pulmonary vascular and ductus arteriosus responses. Interference in blood flow and oxygen content may affect cerebral development as a result of inadequate oxygen or energy substrate supply. The circulatory effects may be gestational dependent, related to maturation of vascular responses in different organs. These prenatal influences of congenital cardiac defects may severely affect immediate, as well as longterm, postnatal prognosis and survival. This has stimulated the development of techniques for palliation of disturbed circulation during fetal life.