TY - JOUR
T1 - Spontaneous closure of the human fetal ductus arteriosus - A cause of fetal congestive heart failure
AU - Hofstadler, G.
AU - Tulzer, G.
AU - Altmann, R.
AU - Schmitt, K.
AU - Danford, D.
AU - Huhta, J. C.
PY - 1996
Y1 - 1996
N2 - OBJECTIVE: Closure of the fetal ductus arteriosus, which is usually due to nonsteroidal antiinflammatory agents, may be detrimental. Therefore prenatal and postnatal clinical and echocardiographic findings in four human fetuses with spontaneous ductus arteriosus occlusion are reported. STUDY DESIGN: Echocardiographic and clinical data were retrospectively analyzed. RESULTS: Spontaneous closure of the ductus arteriosus was discovered in four fetuses (gestational age 34 to 38 weeks). No mother had received nonsteroidal antiinflammatory agents. Enlargement of the right heart and pulmonary arteries and tricuspid and pulmonary regurgitation were present in all cases. Two fetuses had right ventricular hypertension. Postnatally their right ventricular function recovered promptly. The others had severe right heart failure with abnormal umbilical venous pulsations. After immediate delivery none had signs of persistent pulmonary hypertension. However, they have echocardiographic evidence of right ventricular dysfunction 2 to 6 months after delivery. CONCLUSIONS: Occlusion of the fetal ductus arteriosus may also occur in the absence of treatment with nonsteroidal antiinflammatory agents. Immediate delivery resulted in good clinical outcome, although right ventricular dysfunction may persist.
AB - OBJECTIVE: Closure of the fetal ductus arteriosus, which is usually due to nonsteroidal antiinflammatory agents, may be detrimental. Therefore prenatal and postnatal clinical and echocardiographic findings in four human fetuses with spontaneous ductus arteriosus occlusion are reported. STUDY DESIGN: Echocardiographic and clinical data were retrospectively analyzed. RESULTS: Spontaneous closure of the ductus arteriosus was discovered in four fetuses (gestational age 34 to 38 weeks). No mother had received nonsteroidal antiinflammatory agents. Enlargement of the right heart and pulmonary arteries and tricuspid and pulmonary regurgitation were present in all cases. Two fetuses had right ventricular hypertension. Postnatally their right ventricular function recovered promptly. The others had severe right heart failure with abnormal umbilical venous pulsations. After immediate delivery none had signs of persistent pulmonary hypertension. However, they have echocardiographic evidence of right ventricular dysfunction 2 to 6 months after delivery. CONCLUSIONS: Occlusion of the fetal ductus arteriosus may also occur in the absence of treatment with nonsteroidal antiinflammatory agents. Immediate delivery resulted in good clinical outcome, although right ventricular dysfunction may persist.
KW - Doppler echocardiography
KW - Fetal ductus arteriosus
KW - congestive heart failure
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U2 - 10.1016/S0002-9378(96)70317-4
DO - 10.1016/S0002-9378(96)70317-4
M3 - Article
C2 - 8633660
AN - SCOPUS:0029878966
SN - 0002-9378
VL - 174
SP - 879
EP - 883
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 3
ER -