{"id":2108,"date":"2025-02-16T00:00:00","date_gmt":"2025-02-15T22:00:00","guid":{"rendered":"https:\/\/gynaikologos-komotini.gr\/?p=2108"},"modified":"2026-08-25T17:39:02","modified_gmt":"2026-08-25T14:39:02","slug":"fetal-yenidogan-dolasim","status":"publish","type":"post","link":"https:\/\/gynaikologos-komotini.gr\/tr\/fetal-yenidogan-dolasim\/","title":{"rendered":"Fetal-Yenido\u011fan dola\u015f\u0131m"},"content":{"rendered":"\t\t
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Fetal Dola\u015f\u0131m Fizyolojisi<\/h1>

Kardiyovask\u00fcler sistem fizyolojik ve anatomik a\u00e7\u0131dan tek bir sistem olarak tan\u0131mlansa da, sistemik dola\u015f\u0131m<\/strong> ve pulmoner dola\u015f\u0131m<\/strong> olmak \u00fczere iki dola\u015f\u0131m sistemine ayr\u0131l\u0131r. Fetal dola\u015f\u0131m\u0131n kendine \u00f6zg\u00fc anatomik ve fizyolojik \u00f6zelli\u011fi, plasental dola\u015f\u0131m\u0131n varl\u0131\u011f\u0131 ve fetal dola\u015f\u0131mla ba\u011flant\u0131s\u0131d\u0131r. Plasental dola\u015f\u0131m, sistemik ve pulmoner dola\u015f\u0131mda \u00f6nemli anatomik ve fonksiyonel adaptasyonlar\u0131 gerekli k\u0131lar.<\/p>

Bu farkl\u0131l\u0131klar\u0131n ve do\u011fumdan hemen sonra intrauterin dola\u015f\u0131mdan ekstrauterin dola\u015f\u0131ma ge\u00e7i\u015f s\u0131ras\u0131nda meydana gelen dramatik de\u011fi\u015fikliklerin anla\u015f\u0131lmas\u0131, konjenital kalp hastal\u0131klar\u0131n\u0131n (KKH) ne zaman klinik olarak ortaya \u00e7\u0131kaca\u011f\u0131n\u0131n ve ya\u015fam kurtar\u0131c\u0131 olabilecek tedavi giri\u015fimlerinin ne zaman uygulanmas\u0131 gerekti\u011finin anla\u015f\u0131lmas\u0131 a\u00e7\u0131s\u0131ndan b\u00fcy\u00fck \u00f6nem ta\u015f\u0131r.<\/p>

Do\u011fum Sonras\u0131 Dola\u015f\u0131m Fizyolojisi<\/h2>

Sistemik ve pulmoner dola\u015f\u0131m birbirine seri olarak ba\u011fl\u0131 iki dola\u015f\u0131m sistemi<\/strong> olu\u015fturur. Her sistem bir pompadan (ventrik\u00fcl), kan\u0131 pompaya ta\u015f\u0131yan damarlardan (ven\u00f6z dola\u015f\u0131m) ve kan\u0131 pompadan periferik dokulara ta\u015f\u0131yan damarlardan (arteriyel dola\u015f\u0131m) olu\u015fur.<\/p>

Kan ak\u0131m\u0131n\u0131n y\u00f6n\u00fc (venler\u2013pompa\u2013arterler) takip edildi\u011finde, pulmoner dola\u015f\u0131m; sistemik venler, superior ve inferior vena kava, sa\u011f atriyum, sa\u011f ventrik\u00fcl, pulmoner arter ve pulmoner arterin dallar\u0131ndan ba\u015flayarak akci\u011ferlerin kapiller damarlar\u0131na kadar uzan\u0131r.<\/p>

Sistemik dola\u015f\u0131m ise kan\u0131 akci\u011ferlerden sol atriyuma ta\u015f\u0131yan pulmoner venler, sol atriyum, sol ventrik\u00fcl, aort ve aortun dallar\u0131ndan ba\u015flayarak v\u00fccuttaki organlar\u0131n kapiller damarlar\u0131na kadar uzan\u0131r.<\/p>

Bu iki dola\u015f\u0131m sistemi, akci\u011ferlerin kapiller damarlar\u0131 ve v\u00fccudun di\u011fer organlar\u0131n\u0131n kapiller yataklar\u0131 d\u00fczeyinde birbirine ba\u011flan\u0131r.<\/p>

\u00a0<\/p>

\"\"

Yenido\u011fan dola\u015f\u0131m\u0131<\/strong> (k\u0131rm\u0131z\u0131: oksijenlenmi\u015f kan; mavi: oksijenlenmemi\u015f kan)<\/em><\/p><\/div>

\u0130ki pompa (ventrik\u00fcller), normal ko\u015fullarda birbirleriyle do\u011frudan ba\u011flant\u0131s\u0131 olmayan iki farkl\u0131 dola\u015f\u0131m\u0131 destekler ve her birinin ger\u00e7ekle\u015ftirmesi gereken i\u015f y\u00fck\u00fc farkl\u0131d\u0131r.<\/p>

Sol ventrik\u00fcl, kan\u0131 y\u00fcksek diren\u00e7 ve bas\u0131nca sahip geni\u015f sistemik damar a\u011f\u0131na pompalamak zorundayken, sa\u011f ventrik\u00fcl kan\u0131 daha d\u00fc\u015f\u00fck diren\u00e7 ve bas\u0131nca sahip pulmoner dola\u015f\u0131ma pompalar. Bununla birlikte, her iki ventrik\u00fcl\u00fcn debisi dengeli olarak korunur.<\/p>

Fetal Dola\u015f\u0131m Fizyolojisi<\/h2>

Fetal dola\u015f\u0131mda pulmoner dola\u015f\u0131m anatomik olarak mevcut olmakla birlikte fonksiyonel olarak s\u0131n\u0131rl\u0131d\u0131r; \u00e7\u00fcnk\u00fc fetal kan\u0131n oksijenlenmesi akci\u011ferlerde de\u011fil, plasentada<\/strong> ger\u00e7ekle\u015fir.<\/p>

Dolay\u0131s\u0131yla fetal dola\u015f\u0131m hem pulmoner hem de sistemik dola\u015f\u0131m\u0131<\/strong> i\u00e7erirken, sistemik dola\u015f\u0131m hem fet\u00fcs\u00fcn organlar\u0131n\u0131n hem de plasental dola\u015f\u0131m\u0131n kanlanmas\u0131n\u0131 sa\u011flar.<\/p>

Postnatal dola\u015f\u0131mdan farkl\u0131 olarak bu iki dola\u015f\u0131m fonksiyonel a\u00e7\u0131dan paralel olarak d\u00fczenlenmi\u015ftir<\/strong> ve intrakardiyak bir ba\u011flant\u0131 olan foramen ovale<\/strong> ile ekstrakardiyak bir ba\u011flant\u0131 olan duktus arteriozus<\/strong> arac\u0131l\u0131\u011f\u0131yla birbirine ba\u011flan\u0131r.<\/p>

Plasentada oksijenlenen kan fet\u00fcse umbilikal ven<\/strong> arac\u0131l\u0131\u011f\u0131yla ula\u015f\u0131r. Bu kan\u0131n yakla\u015f\u0131k %50’si duktus venozus<\/strong> arac\u0131l\u0131\u011f\u0131yla karaci\u011feri bypass ederek inferior vena kavaya ula\u015f\u0131r ve buradan sa\u011f atriyuma girer. Nispeten y\u00fcksek d\u00fczeyde oksijen i\u00e7eren bu kan\u0131n b\u00fcy\u00fck b\u00f6l\u00fcm\u00fc foramen ovale arac\u0131l\u0131\u011f\u0131yla sol atriyuma (sa\u011fdan sola \u015fant<\/strong>) ve ard\u0131ndan sol ventrik\u00fcle y\u00f6nlendirilir.<\/p>

Umbilikal venden gelen oksijenlenmi\u015f kan\u0131n geri kalan yakla\u015f\u0131k %50’si karaci\u011feri perf\u00fcze eder ve daha sonra hepatik venler arac\u0131l\u0131\u011f\u0131yla inferior vena kavaya ula\u015farak sa\u011f atriyuma y\u00f6nelir.<\/p>

Sol ventrik\u00fclden kan \u00e7\u0131kan aortaya pompalan\u0131r. Kan\u0131n yakla\u015f\u0131k %90’\u0131 fet\u00fcs\u00fcn \u00fcst k\u0131sm\u0131na, \u00f6zellikle beyne<\/strong>, y\u00f6nelirken yakla\u015f\u0131k %10’u aort istmusu \u00fczerinden inen aortaya devam eder. B\u00f6ylece oksijen i\u00e7eri\u011fi en y\u00fcksek olan kan\u0131n b\u00fcy\u00fck b\u00f6l\u00fcm\u00fc \u00f6zellikle beyin gibi hayati organlara y\u00f6nlendirilmi\u015f olur.<\/p>

.<\/p>

\"\"

Fetal dola\u015f\u0131m<\/strong> (k\u0131rm\u0131z\u0131: oksijenlenmi\u015f kan; mavi: oksijenlenmemi\u015f kan)<\/em><\/p><\/div>

Beyne oksijenini b\u0131rakt\u0131ktan sonra daha az oksijen i\u00e7eren kan superior vena kava arac\u0131l\u0131\u011f\u0131yla sa\u011f atriyuma geri d\u00f6ner. Burada inferior vena kavadan gelen kanla kar\u0131\u015f\u0131r ve ard\u0131ndan sa\u011f ventrik\u00fcle ve pulmoner artere ge\u00e7er.<\/p>

Fetal pulmoner vask\u00fcler diren\u00e7 y\u00fcksek oldu\u011fundan, sa\u011f ventrik\u00fcl debisinin yaln\u0131zca yakla\u015f\u0131k %10’u pulmoner arterler arac\u0131l\u0131\u011f\u0131yla akci\u011ferlere ula\u015f\u0131r. Yakla\u015f\u0131k %90’\u0131 ise akci\u011ferleri duktus arteriozus<\/strong> \u00fczerinden bypass ederek (sa\u011fdan sola \u015fant<\/strong>) inen aortaya ge\u00e7er.<\/p>

\u00a0<\/p>

Bu nedenle inen aortada nispeten oksijenlenmi\u015f kan ile daha d\u00fc\u015f\u00fck oksijen i\u00e7eri\u011fine sahip kan\u0131n kar\u0131\u015f\u0131m\u0131 bulunur. Bu kan\u0131n bir b\u00f6l\u00fcm\u00fc fetal organlara y\u00f6nelir ve daha sonra inferior vena kavaya geri d\u00f6ner; di\u011fer b\u00f6l\u00fcm\u00fc ise umbilikal arterler<\/strong> ve umbilikal kord arac\u0131l\u0131\u011f\u0131yla plasentaya geri ta\u015f\u0131n\u0131r.<\/p>

Plasentada fetal kan, uterin arterler taraf\u0131ndan sa\u011flanan maternal dola\u015f\u0131mla ger\u00e7ekle\u015fen gaz de\u011fi\u015fimi sayesinde yeniden oksijenlenir ve ayn\u0131 dola\u015f\u0131m d\u00f6ng\u00fcs\u00fc tekrar ba\u015flar.<\/p>

B\u00f6ylece sol ventrik\u00fcl a\u011f\u0131rl\u0131kl\u0131 olarak beyin ve \u00fcst v\u00fccuda kan sa\u011flarken<\/strong>, sa\u011f ventrik\u00fcl akci\u011ferlere daha az, v\u00fccudun alt b\u00f6l\u00fcm\u00fcne ve plasentaya ise daha fazla kan g\u00f6nderir<\/strong>.<\/p>

Bu nedenle fetal dola\u015f\u0131m paralel ve kar\u0131\u015f\u0131k bir dola\u015f\u0131m<\/strong> olarak tan\u0131mlan\u0131r ve sa\u011f ventrik\u00fcl debisi sol ventrik\u00fcl debisinin yakla\u015f\u0131k 1,4 kat\u0131d\u0131r<\/strong>.<\/p>

Gebelik ilerledik\u00e7e plasental ve pulmoner vask\u00fcler diren\u00e7lerdeki de\u011fi\u015fikliklere paralel olarak plasental ve pulmoner kan ak\u0131m\u0131nda da de\u011fi\u015fiklikler meydana gelir.<\/p>

Fetal Dola\u015f\u0131mdan Yenido\u011fan Dola\u015f\u0131m\u0131na Ge\u00e7i\u015f<\/h2>

Do\u011fumdan hemen sonra dola\u015f\u0131m sisteminde \u00f6nemli de\u011fi\u015fiklikler meydana gelir. Plasentan\u0131n dola\u015f\u0131mdan ayr\u0131lmas\u0131yla d\u00fc\u015f\u00fck diren\u00e7li plasental damar yata\u011f\u0131 ortadan kalkar ve bunun sonucunda sistemik vask\u00fcler diren\u00e7 ve sistemik arteriyel bas\u0131n\u00e7 h\u0131zla artar<\/strong>.<\/p>

Ayn\u0131 zamanda akci\u011ferlerin havalanmas\u0131 ve geni\u015flemesi pulmoner vask\u00fcler direncin belirgin \u015fekilde azalmas\u0131na ve pulmoner kan ak\u0131m\u0131n\u0131n \u00f6nemli \u00f6l\u00e7\u00fcde artmas\u0131na neden olur. Bunun sonucunda pulmoner venler arac\u0131l\u0131\u011f\u0131yla sol atriyuma d\u00f6nen kan miktar\u0131 artar.<\/p>

Sol atriyum bas\u0131nc\u0131n\u0131n artmas\u0131, foramen ovale<\/strong> d\u00fczeyindeki bas\u0131n\u00e7 gradiyentini tersine \u00e7evirir. B\u00f6ylece k\u0131sa s\u00fcreli soldan sa\u011fa ak\u0131m e\u011filimi olu\u015fur ve foramen ovalenin kapak mekanizmas\u0131n\u0131 olu\u015fturan septum primum<\/strong>, septum secundum<\/strong> ile temas eder. Bunun sonucunda foramen ovalenin fonksiyonel kapanmas\u0131<\/strong> ger\u00e7ekle\u015fir.<\/p>

Akci\u011fer solunumunun ba\u015flamas\u0131yla arteriyel kandaki oksijen d\u00fczeyi y\u00fckselir. Arteriyel oksijen parsiyel bas\u0131nc\u0131ndaki art\u0131\u015f ve dola\u015f\u0131mdaki prostaglandin d\u00fczeylerinin azalmas\u0131, duktus arteriozusun konstriksiyonuna ve ard\u0131ndan kapanmas\u0131na<\/strong> yol a\u00e7ar.<\/p>

B\u00f6ylece sa\u011f ventrik\u00fcl sistemik dola\u015f\u0131ma katk\u0131da bulunan bir pompa olma \u00f6zelli\u011fini kaybeder. Duktus arteriozusun kapanmas\u0131yla inen aorta ile olan fetal ba\u011flant\u0131s\u0131 ortadan kalkar ve sa\u011f ventrik\u00fcl yaln\u0131zca d\u00fc\u015f\u00fck bas\u0131n\u00e7l\u0131 pulmoner dola\u015f\u0131ma<\/strong> kan pompalayan ventrik\u00fcl haline gelir.<\/p>

\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Fetal Dola\u015f\u0131m Fizyolojisi Kardiyovask\u00fcler sistem fizyolojik ve anatomik a\u00e7\u0131dan tek bir sistem olarak tan\u0131mlansa da, sistemik dola\u015f\u0131m ve pulmoner dola\u015f\u0131m olmak \u00fczere iki dola\u015f\u0131m sistemine ayr\u0131l\u0131r. [\u2026]<\/span><\/p>\n","protected":false},"author":3,"featured_media":-1,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[123,89,88],"tags":[],"class_list":["post-2108","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fetusun-anatomik-anomalileri-organ-sistemlerine-gore-icerik","category-kardiyak-defektler","category-konjenital-defektler"],"yoast_head":"\nFetal-Yenido\u011fan dola\u015f\u0131m - \u0391\u03bb\u03ad\u03be\u03b1\u03bd\u03b4\u03c1\u03bf\u03c2 \u039c\u03ac\u03b9\u03bd\u03b1\u03c2 MD, PhD<\/title>\n<meta name=\"description\" content=\"Kardiyovask\u00fcler sistem fizyolojik ve anatomik a\u00e7\u0131dan tek bir sistem olarak tan\u0131mlansa da, sistemik dola\u015f\u0131m ve pulmoner dola\u015f\u0131m olmak \u00fczere iki dola\u015f\u0131m sistemine ayr\u0131l\u0131r. Fetal dola\u015f\u0131m\u0131n kendine \u00f6zg\u00fc anatomik ve fizyolojik \u00f6zelli\u011fi, plasental dola\u015f\u0131m\u0131n varl\u0131\u011f\u0131 ve fetal dola\u015f\u0131mla ba\u011flant\u0131s\u0131d\u0131r. Plasental dola\u015f\u0131m, sistemik ve pulmoner dola\u015f\u0131mda \u00f6nemli anatomik ve fonksiyonel adaptasyonlar\u0131 gerekli k\u0131lar.\" \/>\n<meta name=\"robots\" content=\"noindex, follow\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Fetal-Yenido\u011fan dola\u015f\u0131m - \u0391\u03bb\u03ad\u03be\u03b1\u03bd\u03b4\u03c1\u03bf\u03c2 \u039c\u03ac\u03b9\u03bd\u03b1\u03c2 MD, PhD\" \/>\n<meta property=\"og:description\" content=\"Kardiyovask\u00fcler sistem fizyolojik ve anatomik a\u00e7\u0131dan tek bir sistem olarak tan\u0131mlansa da, sistemik dola\u015f\u0131m ve pulmoner dola\u015f\u0131m olmak \u00fczere iki dola\u015f\u0131m sistemine ayr\u0131l\u0131r. Fetal dola\u015f\u0131m\u0131n kendine \u00f6zg\u00fc anatomik ve fizyolojik \u00f6zelli\u011fi, plasental dola\u015f\u0131m\u0131n varl\u0131\u011f\u0131 ve fetal dola\u015f\u0131mla ba\u011flant\u0131s\u0131d\u0131r. 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