Fetal Ductal Constriction

Fetal Ductal Constriction

Fetal ductal constriction – Use PI

Tulzer G, Gudmundsson S, Sharkey AM, Wood DC, Cohen AW, Huhta JC: Doppler echocardiography of fetal ductus arteriosus: Constriction versus increased right ventricular output. JACC 18:532-6, 1991

Fetal Ductal Constriction

Constrictors of ductus:AspirinIndomethacinIbuprofenNonsteroidal anti-inflammatorydrugs

Fetal Ductal Constriction

Ductal constriction: can occur either in singleton or multiple pregnancies.

Course: Ductal constriction can lead to total ductal occlusion in utero. Chronic constriction can lead to ductal changes

Treatment: Withdrawal of causative medicine

Post natal: Persistent PDA is reported

Fetal Ductal Constriction

Fetal Ductal Constriction

Withdrawal of the medicine should result in resolution

of constriction/occlusion within 2-3 days.

Tricuspid regurgitation dP/dt

50

100

150

200

250

300 dt

0

50

cm/sec

TRdP

32100

250

500

750

1000

1250

1500

Survivors

Non-Survivors

Doppler-Derived Right Ventricular dP/dt

dP/dt(mmHg/s)

Ductal Constriction NIHF

Fetal Ductal Constriction

Chronic spontaneous constriction could lead to changes in the pulmonary vascular bed from fetal pulmonary hypertension and pulmonary arteriolar muscularization. The maternal hyperoxygenation test is suggested after 30 weeks gestation in such cases to exclude pulmonary vascular abnormal reactivity.