title: Reversal of fetal ductal constriction after maternal restriction of polyphenol-rich foods: an open clinical trial.
abstract: OBJECTIVE
  To test the hypothesis that maternal restriction of polyphenol-rich foods (PRF), which, like non-steroidal anti-inflammatory drugs (NSAID), inhibit prostaglandin synthesis in the third trimester, reverse fetal ductal constriction (DC).
  
  
  METHODS
  An open clinical trial of 51 third trimester fetuses with DC with no history of NSAID intake was designed. All mothers were submitted to a food frequency questionnaire and were oriented to withdrawl PRF, being reassessed after 3 weeks. Doppler parameters were assessed before and after discontinuation of these substances. A control group of 26 third trimester normal fetuses, with no ductus arteriosus (DA) constriction, in which no dietary intervention was offered, was reviewed after 3 weeks. Student's t-test and Wilcoxon's test were used.
  
  
  RESULTS
  Mean gestational age was 32±3 weeks (28 to 37 weeks). After discontinuation of PRF (≥3 weeks), 48/51 fetuses (96%) showed complete reversal of DC, with decrease in mean ductal systolic velocity (1.74±0.20 m s(-1) to 1.31±0.34 m s(-1), P<0.001), mean diastolic velocity (0.33±0.09 m s(-1) to 0.21±0.07 m s(-1), P<0.001) and mean right to left ventricular dimension ratio (1.37±0.26 to 1.12±0.17, P<0.001) and increase in mean ductal pulsatility index (PI) (1.98±0.36 to 2.46±0.23, P<0.001). Median daily maternal consumption of PRF was 286 mg per day and decreased after orientation to 0 mg per day, P<0.001. In the control group, with GA of 32±4 w (29-37 w), there was no significant differences in median daily maternal consumption of PRF, mean ductal systolic velocitiy, diastolic velocity, PI and right ventricular to left ventricular diameter ratio (RV/LV) ratio.
  
  
  CONCLUSIONS
  Reduction of maternal PRF intake during pregnancy, especially in the third trimester, is followed by complete reversal of DC (wide open DA), which may influence maternal dietary habits in late pregnancy.
authors: Fetal Cardiology Unit, Instituto de Cardiologia do Rio Grande do Sul/ FUC (IC/FUC), Porto Alegre, Brazil. zielinsky@cardiol.br
authors: P
authors: P
authors: Zielinsky
authors: A L
authors: AL
authors: Piccoli
authors: J L L
authors: JL
authors: Manica
authors: L H
authors: LH
authors: Nicoloso
authors: I
authors: I
authors: Vian
authors: L
authors: L
authors: Bender
authors: P
authors: P
authors: Pizzato
authors: M
authors: M
authors: Pizzato
authors: F
authors: F
authors: Swarowsky
authors: C
authors: C
authors: Barbisan
authors: A
authors: A
authors: Mello
authors: S C
authors: SC
authors: Garcia
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D001783:Blood Flow Velocity; D003251:Constriction, Pathologic; D004373:Ductus Arteriosus / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000187:drug effects*; D006801:Humans; D059808:Polyphenols / Q000494:pharmacology*; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D059808:Polyphenols