PRENATAL-DIAGNOSIS OF IDIOPATHIC STENOSIS OF THE DUCTUS-ARTERIOSUS ASSOCIATED WITH FETAL ATRIAL-FLUTTER

Antenatal stenosis or closure of the ductus arteriosus unrelated to ei ther congenital heart defects or prostaglandin inhibitors is considere d to be uncommon, but may result in congestive heart failure, hydrops fetalis, and perinatal death. We report a case of idiopathic ductal st enosis detected prenatally by two-dimensional and Doppler echocardiogr aphy in a fetus presenting atrial flutter and right atrial dilatation at 31 weeks of gestation. Prenatal treatment with digoxin and verapami l resulted in conversion to sinus rhythm, The fetus was closely monito red, Congestive heart failure did not develop, and the fetus was deliv ered spontaneously in good condition at 39 weeks of gestation. In case of ductal stenosis, the potential risk of congestive heart failure mu st be considered, and maternal administration of drugs with constricti ve effects on the ductus arteriosus, as indomethacin or betamethasone, should be avoided.