Idiopathic severe constriction of the fetal ductus arteriosus: a possible underestimated pathophysiology.
Summary of "Idiopathic severe constriction of the fetal ductus arteriosus: a possible underestimated pathophysiology."
Idiopathic intrauterine constriction/closure of the ductus arteriosus, which is distinct from that secondary to maternal exposure to non-steroidal anti-inflammatory drugs, such as indomethacin, or structural cardiac defect, is an uncommon event that often results in severe fetal-neonatal morbidity and mortality. We reported a case of idiopathic fetal ductal constriction, in which the diagnosis was confirmed by documentation of an abnormal four-chamber view of the fetal heart at 38 weeks of gestation on obstetric ultrasound examination. A female infant weighing 2,816 g was born by Cesarean section, and her postnatal course was mild; transient tachypnea requiring only several days of supplemental oxygen with spontaneous regression of the abnormal echocardiographic findings by 3 months of age. The incidence of idiopathic constriction/closure of the fetal ductus arteriosus may be underestimated, particularly with a negative history of maternal drug exposure and mild postnatal clinical presentation.
Affiliation
Department of Pediatrics, Nippon Medical School, Tokyo, Japan, shima-p@nms.ac.jp.
Journal Details
This article was published in the following journal.
Name: European journal of pediatrics
ISSN: 1432-1076
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20845046
- DOI: http://dx.doi.org/10.1007/s00431-010-1295-3
Medical and Biotech [MESH] Definitions
Ductus Arteriosus, Patent
A congenital heart defect characterized by the persistent opening of fetal DUCTUS ARTERIOSUS that connects the PULMONARY ARTERY to the descending aorta (AORTA, DESCENDING) allowing unoxygenated blood to bypass the lung and flow to the PLACENTA. Normally, the ductus is closed shortly after birth.
Persistent Fetal Circulation Syndrome
A syndrome of persistent PULMONARY HYPERTENSION in the newborn infant (INFANT, NEWBORN) without demonstrable HEART DISEASES. This neonatal condition can be caused by severe pulmonary vasoconstriction (reactive type), hypertrophy of pulmonary arterial muscle (hypertrophic type), or abnormally developed pulmonary arterioles (hypoplastic type). The newborn patient exhibits CYANOSIS and ACIDOSIS due to the persistence of fetal circulatory pattern of right-to-left shunting of blood through a patent ductus arteriosus (DUCTUS ARTERIOSUS, PATENT) and at times a patent foramen ovale (FORAMEN OVALE, PATENT).
Ductus Arteriosus
A fetal blood vessel connecting the pulmonary artery with the descending aorta.
Hypoplastic Left Heart Syndrome
A condition caused by underdevelopment of the whole left half of the heart. It is characterized by hypoplasia of the left cardiac chambers (HEART ATRIUM; HEART VENTRICLE), the AORTA, the AORTIC VALVE, and the MITRAL VALVE. Severe symptoms appear in early infancy when DUCTUS ARTERIOSUS closes.
Truncus Arteriosus
The arterial trunk arising from the fetal heart. During development, it divides into AORTA and the PULMONARY ARTERY.
PubMed Articles
Idiopathic Occlusion of the Fetal Ductus Arteriosus without Lumen Narrowing.
Constriction of the fetal ductus arteriosus in utero can be caused by pharmacological agents or can occur spontaneously. The spontaneous constriction and closure of the ductus arteriosus have been rep...
Idiopathic constriction of the fetal ductus arteriosus: three cases and review of the literature.
Premature constriction or closure of the ductus arteriosus can occur during fetal life. It is a rare phenomenon and has been described secondary to medication or structural lesions or as idiopathic co...
Postnatal closure of the ductus arteriosus is crucial in the circulatory adaptation of the newborn to extrauterine life. In recent years, many studies have been performed to improve our understanding...
Estimation of patent ductus arteriosus diameters by colour Doppler echocardiography in children.
OBJECTIVE: To investigate whether accurate estimation of the diameter of the patent ductus arteriosus can be obtained by colour Doppler echocardiography. METHODS: The minimum and maximum diameters of...
History of the Ductus Arteriosus: 1. Anatomy and Spontaneous Closure.
Ductus arteriosus and foramen ovale were described by Galen without understanding their functions. His beliefs in soul localization and spiritization within the left ventricle established religious pn...
Clinical Trials
Patent Ductus Arteriosus (PDA) Screening Trial
The ductus arteriosus directs blood away from the pulmonary circulation and toward the systemic circulation during fetal life, then closes after birth. In preterm infants the incidence of...
Second Course of Therapy for Resistant Patent Ductus Arteriosus (PDA)
Patency of the ductus arteriosus (PDA) is functionally essential for fetal circulation, however persistence of ductal patency postnatally may have significant adverse hemodynamic effects i...
The purpose of the study is to determine the safety and efficacy of ibuprofen, compared with indomethacin, in the treatment for the closure of the patent ductus arteriosus in premature bab...
Safety/Efficacy Study of Optimizing Ibuprofen Dosing to Achieve Higher PDA Closure Rates
The purpose of this study is to determine if increasing the ibuprofen dose will increase the likelihood of closing the patent ductus arteriosus in premature babies.
Nitric Oxide, Endothelin-1, and the Patency of Ductus Arteriosus in Preterm Infants
BACKGROUND Patent ductus arteriosus (PDA) is a frequent clinical event in preterm infant. The cardiopulmonary functions of these preterm babies may be adversely affected by the patency of...
