Summary
Treatment of preterm labor with nonsteroidal antiinflammatory agents can lead to acute, transient changes in the caliber of the fetal ductus arteriosus. These changes can be detected and quantitated using fetal echocardiography. This complication can be successfully managed with serial study of the fetus using Doppler techniques and may be indicated serially. The β-agonist sympathomimetic medications used to treat preterm labor, such as terbutaline, have an immediate effect on the fetal circulation and increase the heart rate and the inotropic state of the fetal myocardium. The future will see improved methods of fetal testing to assess the effects of both preterm labor and its treatment on the fetal circulation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Huhta JC, Moise KJ, Fisher DJ et al (1987) Detection and quantitation of constriction of the fetal ductus arteriosus by Doppler echocardiography. Circulation 75:406–412
Moise KJ, Huhta JC, Sharif DS et al (1988) Indomethacin in the treatment of premature labor: effects on the fetal ductus arteriosus. Engl J Med 319:727–731
Levin DL, Mills LJ, Parkey M, Garriott J, Campbell W (1979) Constriction of the fetal ductus arteriosus after administration of indomethacin to the pregnant ewe. Pediatrics 94:647–650
Huhta JC, Cohen A, Wood DC (1990) Premature constriction of the ductus arteriosus. J Am Soc Echocardiogr 3:30–34
Levin DL, Mills LJ, Weinberg AG (1979) Hemodynamic, pulmonary vascular, and myocardial abnormalities secondary to pharmacologic constriction of the fetal ductus arteriosus. Circulation 60:360–364
Momma K, Takao A (1989) Right ventricular concentric hypertrophy and left ventricular dilatation by ductal constriction in fetal rats. Circ Res 64:1137–1146
Wild LM, Nickerson PA, Morin III FC (1989) Ligating the ductus arteriosus before birth remodels the pulmonary vasculature of the lamb. Pediatr Res 25:251–257
Morin III FC (1989) Ligating the ductus arteriosus birth causes persistent pulmonary hypertension in the newborn lamb. Pediatr Res 25:245–250
Sharif DS, Huhta JC, Moise KJ, Morrow RW, Yoon GY (1990) Changes in fetal hemodynamics with terbutaline treatment and premature labor. J Clin Ultrasound 18:85–89
Gudmundsson S, Huhta JC, Wood DC et al (1991) Venous Doppler ultrasonography in the fetus with non-immune hydrops. Am J Obstet Gynecol 164:33–37
Tulzer G et al (1994) Doppler in hydrops non-immune fetalis. Ultrasound in Obstet Gynecol 4:279–283
Respondek ML, Kammermeier M, Ludomirsky A, Weil SR, Huhta JC (1994) The prevalence and clinical significance of fetal tricuspid valve regurgitation. Am J Obstet Gynecol 171:1265–1270
Tulzer G, Gudmundsson S, Sharkey A et al (1991) Doppler echocardiography of fetal ductus arteriosus constriction versus increased right ventricular output. J am Cell Cardiol 18:532–536
Rasanen J, Wood DC, Weiner S, Ludomirski A, Huhta JC (1996) Role of the pulmonary circulation in the distribution of human fetal cardiac output during the second half of pregnancy. Circulation 94:1068–1073
Rasanen J, Debbs RH, Wood DC, Weiner S, Huhta JC (1999) The effects of maternal indomethacin therapy on human fetal branch pulmonary arterial vascular impedance. Ultrasound Obstet Gynecol 13:112–116
Rasanen J, Wood DC, Debbs RH, Cohen J, Weiner S, Huhta JC (1998) Reactivity of the human fetal pulmonary circulation to maternal hyperoxygenation increases during the second half of pregnancy: a randomized study. Circulation 97:257–262
Broth RE, Wood DC, Rasanen J, Sabogal JC, Komwilaisak R, Weiner S, Berghella V (2002) Prenatal prediction of lethal pulmonary hypoplasia: the hyperoxygenation test for pulmonary artery reactivity. Am J Obstet Gynecol 187:940–945
Sylvester KG, Rasanen J, Kitano Y, Flake AW, Crombleholme TM, Adzick NS (1998) Tracheal occlusion reverses the high impedance to flow in the fetal pulmonary circulation and normalizes its physiological response to oxygen at full term. J Pediatr Surg 33:1071–1074; discussion 1074-1075
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Huhta, J.C., Tulzer, G., Weil-Chalker, S.R. (2005). Evaluation of Pulmonary and Ductal Vasculature: Fetal Echocardiography for Evaluation of Therapy for Preterm Labor. In: Maulik, D. (eds) Doppler Ultrasound in Obstetrics and Gynecology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28903-8_37
Download citation
DOI: https://doi.org/10.1007/3-540-28903-8_37
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-23088-5
Online ISBN: 978-3-540-28903-6
eBook Packages: MedicineMedicine (R0)