Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T13:34:18.294Z Has data issue: false hasContentIssue false

Clinical course of a fetus with hypoplastic left heart syndrome and premature ductal constriction

Published online by Cambridge University Press:  27 December 2018

Anita Krishnan*
Affiliation:
Division of Cardiology, Children’s National Medical Center, Washington, DC, USA
Lauren Tague
Affiliation:
Division of Cardiology, Children’s National Medical Center, Washington, DC, USA
Harish Rudra
Affiliation:
Department of Pediatrics, Fairfax Inova Hospital, Falls Church, VA, USA
Subechhya Pradhan
Affiliation:
Department of Radiology, Children’s National Medical Center, Washington, DC, USA
Gilbert Vezina
Affiliation:
Department of Radiology, Children’s National Medical Center, Washington, DC, USA
Catherine Limperopoulos
Affiliation:
Department of Radiology, Children’s National Medical Center, Washington, DC, USA
*
Author for correspondence: A. Krishnan, MD, Children’s National Medical Center, Department of Cardiology, 111 Michigan Avenue NW, Suite WW3-200, Washington, DC, 20010, USA. Tel: +(202) 476-2020; E-mail: [email protected]

Abstract

Premature ductal constriction was diagnosed in a 30-week gestation fetus with hypoplastic left heart syndrome. The fetus developed right ventricular hypertrophy and mild tricuspid regurgitation. Foetal neuroimaging showed slowed growth of the brain and increased lactate. We describe the imaging and clinical findings. Fetuses with critical CHD and in utero ductal constriction are at increased risk of morbidity and mortality, and require appropriate counselling.

Type
Brief Report
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Krishnan A, Tague L, Rudra H, Pradhan S, Vezina G, Limperopoulos C. (2018) Clinical course of a fetus with hypoplastic left heart syndrome and premature ductal constriction. Cardiology in the Young page 216 of 218. doi: 10.1017/S1047951118001701

References

1. Evangelou, IE, du Plessis, AJ, Vezina, G, Noeske, R, Limperopoulos, C. Elucidating metabolic maturation in the healthy fetal brain using 1H-MR spectroscopy. AJNR Am J Neuroradiol 2016; 37: 360366.10.3174/ajnr.A4512Google Scholar
2. Andescavage, NN, du Plessis, A, McCarter, R, et al. Complex trajectories of brain development in the healthy human fetus. Cereb Cortex 2017; 27: 52745283.Google Scholar
3. Zielinsky, P, Busato, S. Prenatal effects of maternal consumption of polyphenol-rich foods in late pregnancy upon fetal ductus arteriosus. Birth Defects Res C Embryo Today 2013; 99: 256274.10.1002/bdrc.21051Google Scholar
4. Zielinsky, P, Piccoli, AL Jr, Manica, JL, et al. Maternal consumption of polyphenol-rich foods in late pregnancy and fetal ductus arteriosus flow dynamics. J Perinatol 2010; 30: 1721.Google Scholar
5. Huhta, JC, Moise, KJ, Fisher, DJ, et al. Detection and quantitation of constriction of the fetal ductus arteriosus by Doppler echocardiography. Circulation 1987; 75: 406412.10.1161/01.CIR.75.2.406Google Scholar
6. Limperopoulos, C, Tworetzky, W, McElhinney, DB, et al. Brain volume and metabolism in fetuses with congenital heart disease: evaluation with quantitative magnetic resonance imaging and spectroscopy. Circulation 2010; 121: 2633.Google Scholar
7. Cetin, I, Barberis, B, Brusati, V, et al. Lactate detection in the brain of growth-restricted fetuses with magnetic resonance spectroscopy. Am J Obstet Gynecol 2011; 205: 350.e1350.e7.Google Scholar
8. Cheong, JL, Cady, EB, Penrice, J, et al. Proton MR spectroscopy in neonates with perinatal cerebral hypoxic-ischemic injury: metabolite peak-area ratios, relaxation times, and absolute concentrations. AJNR Am J Neuroradiol 2006; 27: 15461554.Google Scholar
9. Goergen, SK, Ang, H, Wong, F, et al. Early MRI in term infants with perinatal hypoxic-ischaemic brain injury: interobserver agreement and MRI predictors of outcome at 2 years. Clin Radiol 2014; 69: 7281.10.1016/j.crad.2013.09.001Google Scholar
10. Shu, SK, Ashwal, S, Holshouser, BA, Nystrom, G, Hinshaw, DB Jr. Prognostic value of 1H-MRS in perinatal CNS insults. Pediatr Neurol 1997; 17: 309318.10.1016/S0887-8994(97)00140-9Google Scholar
11. Huhta, JC, Vick, GW 3rd, Carpenter, RA, Gutgesell, HP. Transient neonatal tricuspid regurgitation: possible relation with premature closure of the ductus arteriosus. J Am Coll Cardiol 1984; 4: 651.Google Scholar
Supplementary material: File

Krishnan et al. supplementary material

Krishnan et al. supplementary material 1

Download Krishnan et al. supplementary material(File)
File 4.5 MB