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Possible association between maternal lithium therapy and premature closure of the arterial duct. A case report
Dana L Ellis1, Vitor Guerra, Gabriella Pridjian
1Section of Pediatric Cardiology, Tulane University School of Medicine, New Orleans, Louisiana, USA. dellis1@tulane.edu
Background:
Frequent causes of premature ductal closure include spontaneous idiopathic closure in utero and maternal use of nonsteroidal anti-inflammatory drugs late in pregnancy.
Case:
We describe a case of a preterm infant born to a mother treated with lithium throughout pregnancy who presented with right-sided cardiac enlargement at 18 weeks' gestation. Immediately following delivery, echocardiography demonstrated a small closing patent arterial duct.
Conclusion:
We recommend that serial fetal echocardiography with emphasis on Doppler interrogation of the patent arterial duct be performed whenever a pregnant woman is taking lithium. The interrogation of the patent arterial duct is particularly important if right-sided chamber enlargement is noted at fetal sonography as this finding can be an early manifestation of premature ductal constriction.
