In several Fellowship Exam papers (but none since 2007) the exam candidates were asked to describe the changes to the foetal circulation which occur after birth, and the various pathological states which interfere with this normal process. However, ever since the establishment of an official CICM Primary Exam, this matter appears to have been exiled into the First Part Syllabus. To that effect, there is a rather detailed summary on the circulatory changes in the newborn in the First Part exam preparation section. Here, the time-poor exam candidate's time will not be wasted with any further digressions into physiology, considering especially the possibility that this topic will never appear in the Second Part again.
Previous SAQs on this topic included the following:
In brief summary:
At birth,
Causes of a persistent foetal circulation:
Causes of reversion to foetal circulation:
Fishman, Alfred P., and Dickinson W. Richards. "Physiological changes in the circulation after birth." Circulation of the Blood. Springer New York, 1982. 743-816.
van Vonderen, Jeroen J., et al. "Measuring physiological changes during the transition to life after birth." Neonatology 105.3 (2014): 230-242.
Koos, Brian J., and Arezoo Rajaee. "Fetal breathing movements and changes at birth." Advances in Fetal and Neonatal Physiology. Springer New York, 2014. 89-101.
Hooper, Stuart B., et al. "Cardiovascular transition at birth: a physiological sequence." Pediatric research (2015).
D’cunha, Chrysal, and Koravangattu Sankaran. "Persistent fetal circulation." Paediatrics & child health 6.10 (2001): 744.