Hofstadler G, Tulzer G, Altmann R, Schmitt K, Danford D, Huhta J C
Department of Pediatric Cardiology, Children's Hospital of Linz, Austria.
Am J Obstet Gynecol. 1996 Mar;174(3):879-83. doi: 10.1016/s0002-9378(96)70317-4.
Closure of the fetal ductus arteriosus, which is usually due to nonsteroidal antiinflammatory agents, may be detrimental. Therefore prenatal and postnatal clinical and echocardiographic findings in four human fetuses with spontaneous ductus arteriosus occlusion are reported.
Echocardiographic and clinical data were retrospectively analyzed.
Spontaneous closure of the ductus arterious was discovered in four fetuses (gestational age 34 to 38 weeks). No mother had received nonsteroidal antiinflammatory agents. Enlargement of the right heart and pulmonary arteries and tricuspid and pulmonary regurgitation were present in all cases. Two fetuses had right ventricular hypertension. Postnatally their right ventricular function recovered promptly. The others had severe right heart failure with abnormal umbilical venous pulsations. After immediate delivery none had signs of persistent pulmonary hypertension. However, they have echocardiographic evidence of right ventricular dysfunction 2 to 6 months after delivery.
Occlusion of the fetal ductus arteriosus may also occur in the absence of treatment with nonsteroidal antiinflammatory agents. Immediate delivery resulted in good clinical outcome, although right ventricular dysfunction may persist.
胎儿动脉导管的闭合通常是由非甾体类抗炎药引起的，这可能是有害的。因此，本文报告了4例胎儿动脉导管自发闭合的产前和产后临床及超声心动图检查结果。
对超声心动图和临床数据进行回顾性分析。
在4例胎儿（孕周34至38周）中发现动脉导管自发闭合。没有母亲使用过非甾体类抗炎药。所有病例均出现右心和肺动脉扩大以及三尖瓣和肺动脉反流。2例胎儿有右心室高压。出生后他们的右心室功能迅速恢复。其他胎儿有严重的右心衰竭和异常的脐静脉搏动。立即分娩后，无一例有持续性肺动脉高压的迹象。然而，他们在分娩后2至6个月有右心室功能障碍的超声心动图证据。
在未使用非甾体类抗炎药治疗的情况下，胎儿动脉导管也可能发生闭合。立即分娩可取得良好的临床结果，尽管右心室功能障碍可能会持续存在。
