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.
Shima
Yoshio
Y
Department of Pediatrics, Nippon Medical School, Tokyo, Japan. shima-p@nms.ac.jp
Ishikawa
Hiroko
H
Matsumura
Yoshikatsu
Y
Yashiro
Kentaro
K
Nakajima
Mizue
M
Migita
Makoto
M
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