Fetal Ductal Constriction, Pulmonary Hypertension and Atrial Septum Mobility: A Correlation Study

Fetuses with ductal constriction (FDC), pulmonary hypertension and right ventricular overload after maternal exposure to PGE2 inhibitors-nonsteroidal anti-inflammatory drugs (NSAIDs) or polyphenols (PF)-have increased septum primum excursion index (SPEI), the ratio between maximal septum primum displacement and left atrial diameter. The objective of this study is to assess SPEI behavior and its correlation to mean pulmonary artery pressure (MPAP) after ductal constriction (DC) resolution.

Cohort study comparing SPEI and MPAP during and 2 weeks after DC reversal, following discontinuation of NSAIDs and PF. Criteria for DC diagnosis were systolic velocity >1.40 m/second, diastolic velocity >0.30 m/second, and pulsatility index <2.2. MPAP was estimated by Dabestani equation: MPAP = 90 - (0.62 × pulmonary artery acceleration time).

t-test and Pearson's correlation.

Fifty-two pregnant women with FDC were evaluated. Following reversal, mean PI increased from 1.89 ± 0.20 to 2.54 ± 0.27 (p < .001), mean SPEI decreased from 0.75 ± 0.13 to 0.42 ± 0.12 (p < .001), and MPAP decreased from 70.33 ± 5.52 mmHg to 53.27 ± 6.68 mmHg (p < .001), with a significant correlation between MPAP and SPEI (r = 0.690).

After resolution of fetal DC, the SPEI decreases, this effect being correlated with reduction in MPAP.