REVIEW PAPER
The foramen ovale from the fetal to neonatal life span
1
Department of Obstetrics and Pathology of Pregnancy, Medical University of Lublin, Poland
Submission date: 2021-01-25
Final revision date: 2021-03-03
Acceptance date: 2021-03-03
Publication date: 2021-03-28
Pediatr Pol 2021;96(1):60-67
KEYWORDS
TOPICS
ABSTRACT
The foramen ovale is an important structure that ensures the functioning of the fetal circulatory system. The work describes process of atrial septum formation from the embryonic stage to the neonatal period. Human atrial septation is inefficient process resulting in a persistent foramen ovale in quarter of adult population. Imaging of the foramen ovale is a valuable parameter for the assessment of the fetal circulatory system with the possibility of capturing life-threatening conditions. The dynamic process of adaptation to extrauterine life is also reflected at the foramen ovale in the postnatal period. The persistent foramen ovale is usually clinically silent in the pediatric population, while in the perspective of adulthood it may be a factor contributing to thromboembolic stroke. The aim of this article is to describe the essential differences in the function of the foramen ovale in the fetal and neonatal period.
REFERENCES (29)
1.
Anderson RH, Spicer DE, Brown NA, Mohun TJ. The development of septation in the four-chambered heart. Anat Rec (Hoboken) 2014; 297: 1414-1429. .
2.
Jensen B, Wang T, Moorman AFM. Evolution and Development of the Atrial Septum. Anat Rec (Hoboken) 2019; 302: 32-48.
3.
Hagen PT, Scholz DG, Edwards WD. Incidence and size of the patent foramen ovale during the first 10 decades of life: An autopsy study of 965 normal hearts. Mayo Clin Proc 1984; 59: 17-20.
4.
Calvert PA, Rana BS, Kydd AC, Shapiro LM. Patent foramen ovale: Anatomy, outcomes, and closure. Nat Rev Cardiol 2011; 8: 148-160.
5.
Tan CMJ, Lewandowski AJ. The transitional heart: from early embryonic and fetal development to neonatal life. Fetal Diagn Ther 2020; 47: 373-386.
6.
Wessels A, Anderson RH, Markwald RR, et al. Atrial development in the human heart: an immunohistochemical study with emphasis on the role of mesenchymal tissues. Anat Rec 2000; 259: 288-300.
7.
Sadler, Thomas W. Langman’s Essential Medical Embryology. Lippincott Williams & Wilkins, Philadelphia 2004.
8.
Männer J, Wessel A, Yelbuz TM. How does the tubular embryonic heart work? Looking for the physical mechanism generating unidirectional blood flow in the valveless embryonic heart tube. Dev Dyn 2010; 239: 1035-1046.
9.
Hiermeier F, Männer J. Kinking and Torsion Can Significantly Improve the Efficiency of Valveless Pumping in Periodically Compressed Tubular Conduits. Implications for Understanding of the Form-Function Relationship of Embryonic Heart Tubes. J Cardiovasc Dev Dis 2017; 4: 19.
10.
Longatti P. The Liebau phenomenon: a translational approach to new paradigms of CSF circulation and related flow disturbances. Childs Nerv Syst 2018; 34: 227-233.
11.
McQuinn TC, Bratoeva M, Dealmeida A, et al. High-frequency ultrasonographic imaging of avian cardiovascular development. Dev Dyn 2007; 236: 3503-3513.
12.
Yelbuz TM, Choma MA, Thrane L, et al. Optical coherence tomography: a new high-resolution imaging technology to study cardiac development in chick embryos. Circulation 2002; 106: 2771-2774.
13.
Acharya G, Gui Y, Cnota W, et al. Human embryonic cardiovascular function. Acta Obstet Gynecol Scand 2016; 95: 621-628.
14.
Wloch A, Rozmus-Warcholinska W, Cnota W, et al. Atrial dominance in the human embryonic heart: a study of cardiac function at 6-10 weeks of gestation. Ultrasound Obstet Gynecol 2015; 46: 553-557.
15.
Kiserud T, Eik-Nes SH, Blaas HG, Hellevik LR. Foramen ovale: an ultrasonographic study of its relation to the inferior vena cava, the ductus venosus and hepatic veins. Ultrasound Obstet Gynecol 1992; 2: 389-396.
16.
Paraskevas G, Koutsouflianiotis K, Iliou K. The first descriptions of various anatomical structures and embryological remnants of the heart: A systematic overview. Int J Cardiol 2017; 227: 674-690.
17.
Respondek-Liberska M. Fetal M-mode echocardiography of the atria in normal heart anatomy and no functional abnormalities. Prenat Cardio 2020; (1): 19-23; doi: 10.5114/pcard.2020.96457.
18.
Pesonen E, Haavisto H, Ammälä P, Teramo K. Intrauterine hydrops caused by premature closure of the foramen ovale. Arch Dis Child 1983; 58: 1015-1016.
19.
Kim HS, Sohn S, Park MY, Choi JY. Coexistence of ductal constriction and closure of the foramen ovale in utero. Pediatr Cardiol 2003; 24: 588-590.
20.
Morin FC, Egan EA. Pulmonary hemodynamics in fetal lambs during development at normal and increased oxygen tension. J Appl Physiol 1992; 73: 213-218.
21.
Hillman NH, Kallapur SG, Jobe AH. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol 2012; 39: 769-783.
22.
Kc A, Singhal N, Gautam J, et al. Effect of early versus delayed cord clamping in neonate on heart rate, breathing and oxygen saturation during first 10 minutes of birth - randomized clinical trial. Matern Health Neonatol Perinatol 2019; 5: 7.
23.
Gao Y, Raj JU. Regulation of the pulmonary circulation in the fetus and newborn. Physiol Rev 2010; 90: 1291-1335.
24.
Rudolph AM. Aortopulmonary transposition in the fetus: speculation on pathophysiology and therapy. Pediatr Res 2007; 61: 375-380.
25.
Morton SU, Brodsky D. Fetal physiology and the transition to extrauterine life. Clin Perinatol 2016; 43: 395-407.
26.
Janiec I, Kucińska B, Werner B. The patent foramen ovale and the secondary-type atrial septal defect – importance and management in children. New Pediatrics 2016; 1: 20-25.
27.
Choi DY, Shin DH, Cho KH, et al. Migraine with aura: A predictor of patent foramen ovale in children and adolescents. Cephalalgia 2013; 33: 63-68.
28.
Wawrzyńczyk M, Gałeczka M, Karwot B, et al. Efficiency of transcatheter patent foramen ovale closure in children after paradoxical embolism events. Kardiol Pol 2016; 74: 385-389.
29.
Khan R, Chan AK, Mondal TK, Paes BA; Thrombosis and Hemostasis in Newborns (THIN) Group. Patent foramen ovale and stroke in childhood: A systematic review of the literature. Eur J Paediatr Neurol 2016; 20: 500-511.
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
