Document Detail


Clinical features of the complete closure of the ductus arteriosus prenatally.
MedLine Citation:
PMID:  21269413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Prenatal constriction of the ductus arteriosus associated with maternal drug ingestion was reported several decades ago. There are fewer reports of the complete closure of the ductus arteriosus; therefore, the clinical features of the latter are poorly understood. The aim of this study is to clarify the clinical features of complete ductal closure and postnatal pulmonary hypertension by performing echocardiography of the fetus.
PATIENTS: We diagnosed four fetuses with complete ductal closure by performing fetal echocardiography and reviewed the prenatal and postnatal medical records of the mother and fetus.
RESULTS: One mother each had bronchial asthma, ulcerative colitis, and idiopathic thrombocytopenic purpura, and they had received nonsteroidal anti-inflammatory drugs and/or corticosteroids during pregnancy. The fourth mother did not have basal disease and had not ingested any drugs. Fetal diagnosis was performed at 32-38 weeks of gestation. All fetuses had right heart dilatation with tricuspid regurgitation in the absence of any cardiac defects, and Doppler echocardiography indicated that the right ventricular pressure was elevated. Two of the fetuses had fetal hydrops, which suggested severe right heart dysfunction. All fetuses were delivered by emergent cesarean delivery. After birth, all the infants developed persistent pulmonary hypertension and required oxygen inhalation. Of these, three required mechanical ventilation, and two, nitric oxide inhalation. All infants improved within 2 weeks, and they had no neurological and cardiac complications after discharge.
CONCLUSION: Right heart dilatation and severe tricuspid regurgitation in the absence of a cardiac defect in the fetus strongly suggested ductal dysfunction. Careful evaluation of ductal patency and right ventricular function can lead to precise early diagnosis and good prognosis.
Authors:
Hidekazu Ishida; Noboru Inamura; Yukiko Kawazu; Futoshi Kayatani
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  6     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-05-09     Revised Date:  2011-09-07    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  51-6     Citation Subset:  IM    
Copyright Information:
© 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc.
Affiliation:
Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. hidehide@fb4.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects*
Adult
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
Cesarean Section
Constriction, Pathologic
Ductus Arteriosus / drug effects*,  embryology,  ultrasonography
Echocardiography, Doppler
Female
Fetal Heart / drug effects*,  ultrasonography
Gestational Age
Humans
Hydrops Fetalis / chemically induced,  physiopathology,  therapy
Hypertrophy, Right Ventricular / chemically induced,  embryology,  therapy,  ultrasonography
Infant, Newborn
Maternal Exposure
Persistent Fetal Circulation Syndrome / chemically induced,  therapy
Pregnancy
Treatment Outcome
Tricuspid Valve Insufficiency / chemically induced,  embryology,  therapy,  ultrasonography
Ultrasonography, Prenatal
Young Adult
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents, Non-Steroidal

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