Katsura Daisuke, Inatomi Ayako, Tokoro Shinsuke, Tsuji Shunichiro, Murakami Takashi
Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, JPN.
Cureus. 2025 Mar 22;17(3):e80983. doi: 10.7759/cureus.80983. eCollection 2025 Mar.
Although premature constriction or closure of the ductus arteriosus (PCDA) is associated with poor prognosis and early delivery is considered before deterioration occurs, some cases may improve and have a good prognosis, but the changes in fetal Doppler during the reopening of the ductus arteriosus are unclear, as are the factors related to its reopening. We encountered two cases of PCDA. In the first case, right cardiac function and ductus venosus flow normalized in a few days and the ductus arteriosus reopened spontaneously, and became vaginal delivery at 37 weeks of gestation. In the second case, labor induction was performed due to confirmed fetal cardiac stress associated with the closure of the ductus arteriosus at 38 weeks of gestation, and cesarean section was performed due to non-reassuring fetal status. The improvement in the right ventricular myocardial performance index, ductus venosus pulsatility index, the tendency for ductus arteriosus diastolic velocity to decrease, and confirmation of prograde flow into the pulmonary artery within a few days could serve as predictive indicators for the reopening of the ductus arteriosus.
尽管动脉导管过早收缩或关闭（PCDA）与预后不良相关，且在病情恶化前会考虑提前分娩，但部分病例可能会改善并具有良好的预后，然而动脉导管重新开放期间胎儿多普勒的变化尚不清楚，与其重新开放相关的因素也不明确。我们遇到了两例PCDA病例。第一例中，右心功能和静脉导管血流在数天内恢复正常，动脉导管自发重新开放，并在妊娠37周时经阴道分娩。第二例中，因在妊娠38周时确诊与动脉导管关闭相关的胎儿心脏应激而行引产，又因胎儿状况不佳而行剖宫产。右心室心肌性能指数、静脉导管搏动指数的改善、动脉导管舒张期速度降低的趋势以及数天内肺动脉正向血流的确认可作为动脉导管重新开放的预测指标。
