title: Idiopathic severe constriction of the fetal ductus arteriosus: a possible underestimated pathophysiology.
abstract: 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.
authors.affiliation: Department of Pediatrics, Nippon Medical School, Tokyo, Japan. shima-p@nms.ac.jp
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Shima
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yashiro
authors.forename: Mizue
authors.initials: M
authors.lastname: Nakajima
authors.forename: Makoto
authors.initials: M
authors.lastname: Migita
mesh_terms: D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004373:Ductus Arteriosus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012720:Severity of Illness Index; D016216:Ultrasonography, Prenatal