Excessive Maternal Orange Intake - A Reversible Etiology of Fetal Premature Ductus Arteriosus Constriction: A Case Report

Rakha, Shaimaa

doi:10.1159/000453063

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…22,23) In addition, some scholars found that excessive intake of polyphenol food is also one of the risk factors. 24,25) However, to date, there is no drug to reopen the closed ductus arteriosus in the premature contraction of ductus arteriosus, and its subsequent development is unpredictable. This makes it more difficult for obstetricians to determine the best time to terminate pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Fetal Ductus Arteriosus Premature Constriction

et al. 2022

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This study aimed to investigate the connections between the echocardiography indices of fetal ductus arteriosus premature constriction and newborn prognosis by analyzing 22 cases of spontaneous fetal ductus arteriosus premature constriction.An ultrasonic instrument was used to observe prenatal fetal heart state, combine clinical examination data and echocardiographic results after delivery, summarize the ultrasound manifestations and imaging characteristics, and analyze the prognosis of the fetus.In all cases, fetal ductus arteriosus premature constriction occurred in the third trimester of pregnancy (34 + 1 to 41 weeks), and no abnormality in extracardiac organs were observed. Seven neonates required respiratory support due to the accompanying severe tricuspid regurgitation. The remaining 15 neonates did not receive respiratory support, including 4 with severe tricuspid regurgitation, 5 with moderate regurgitation, and 6 with mild regurgitation. Significant differences were observed in the fetal right atrium size and tricuspid regurgitation severity between the neonatal respiratory support group and non-respiratory support group. Furthermore, there were statistical differences in the ductus arteriosus inner diameter and pulsation index between the two groups.The severity of fetal ductus arteriosus premature contraction accompanied by tricuspid regurgitation and right atrium enlargement can predict the immediate prognosis of the newborn and provide guidance for the clinical judgment of the timing of pregnancy termination.

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Section: Discussionmentioning

confidence: 99%

Fetal Ductus Arteriosus Premature Constriction

et al. 2022

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“…The mother denied the consumption of any kind of medicine, herbal tea, grapes or other polyphenol-rich food during pregnancy. A dietary intervention for maternal restriction of polyphenol-rich foods or suspension of NSAIDs consumption in the third trimester of pregnancy is accompanied by increase in plasma levels of PGE2 and reversal of foetal ductal constriction [ 10 , 27 , 39 , 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…Premature intra-uterine DA constriction could be diagnosed in complex congenital heart malformations, including Tetralogy of Fallot and truncus arteriosus. As an isolated defect, it is usually secondary to the use of medication like NSAIDs, isoxsuprine, fluoxetine and some foods rich in polyphenol like herbal teas, dark chocolate, orange juice, red/purple grapes, berries and coffee [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Foetal ductus arteriosus constriction unrelated to non-steroidal anti-Inflammatory drugs: a case report and literature review

et al. 2021

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Foetal ductus arteriosus (DA) constriction can be found in complex foetal heart malformations, but rarely as an isolated defect. Although many cases of DA constriction are usually related to Non-steroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake, other causes remain without an established aetiology and are referred to as idiopathic. Recently, a wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) showed a definitive effect upon the pathway of inflammation, causing DA constriction. We report a case of a premature DA constriction in a woman whose possible risk factor was identified in her maternal occupational exposure to solvents and a comprehensive literature review of 176 cases of NSAID-unrelated DA constriction. A 30-year-old Asian woman was referred to our institution at 33 gestational weeks and 0 days because of suspicion of premature DA constriction. The woman had no history of medication intake, including NSAIDs, alcohol, tobacco or polyphenol-rich-food consumption during pregnancy. A detailed foetal echocardiography revealed a normal cardiac anatomy with hypertrophic, hypokinetic and a dilated right ventricle due to right pressure overload, holosystolic tricuspid regurgitation, and, at the level of the DA, high systolic and diastolic velocities, indicating premature ductal restriction. The right outflow showed dilatation of the pulmonary artery with narrow DA. An urgent caesarean section was performed at 33 gestational weeks and 4 days due to worsening of DA PI and signs of right pressure overload, despite the interruption of exposure to solvents. We assume a relationship exists between premature DA constriction and a maternal occupational exposure to solvents. This hypothesis is reinforced by the presence of associated foetal malformations in in two of the patient's children. Further research is needed to confirm the role of exposure to solvents and toxic chemicals in the pathogenesis of DA constriction, also with experimental animal models. KEY MESSAGES1. Many cases of DA constriction are usually related to Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake. 2. A wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) can cause foetal DA constriction. 3. Further investigation are needed to confirm the role of maternal exposure to solvents in the pathogenesis of DA constriction.

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“…Several experimental and clinical studies have reported PCDA after a history of maternal abundant polyphenol consumption. For instance, the use of green tea [176], matè leaf herbal tea infusion [177], or chamomile tea [178], daily intake of prune berry and violet vegetable juice (a blend of 18 vegetables and nine fruits that contains anthocyanins) [179] or MonaVie (a juice blend containing the cyclooxygenase and nitric oxide synthase inhibitors, proanthocyanidins and anthocyanins) [180], or excessive quantities of fresh oranges [181] and dark chocolate [182] in late pregnancy have all been associated with PCDA. The underlying pathogenetic mechanisms are thought to be similar to those involved in PG inhibition by NSAIDs [183].…”

Section: Potential Harmful Effects Of Dietary Polyphenols In Pregnancymentioning

confidence: 99%

“…The underlying pathogenetic mechanisms are thought to be similar to those involved in PG inhibition by NSAIDs [183]. Additionally, analogue to the effects of NSAIDs, PRF-induced PCDA was ameliorated or completely reversed when these substances were discontinued [181,184]. Functional closure of the ductus in healthy term newborns occurs within the first postnatal days, while complete fibrous obliteration develops after several weeks [185].…”

Section: Potential Harmful Effects Of Dietary Polyphenols In Pregnancymentioning

confidence: 99%

The Role of Dietary Polyphenols in Pregnancy and Pregnancy-Related Disorders

et al. 2022

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Polyphenols are a group of phytochemicals with extensive biological functions and health-promoting potential. These compounds are present in most foods of plant origin and their increased widespread availability through the intake of nutritional supplements, fortified foods, and beverages, has also led to increased exposure throughout gestation. In this narrative review, we focus on the role of polyphenols in both healthy and pathological pregnancy. General information related to their classification and function is followed by an overview of their known effects in early-pregnancy events, including the current insights into molecular mechanisms involved. Further, we provide an overview of their involvement in some of the most common pregnancy-associated pathological conditions, such as preeclampsia and gestational diabetes mellitus. Additionally, we also discuss the estimated possible risk of polyphenol consumption on pregnancy outcomes. The consumption of dietary polyphenols during pregnancy needs particular attention considering the possible effects of polyphenols on the mechanisms involved in maternal adaptation and fetal development. Further studies are strongly needed to unravel the in vivo effects of polyphenol metabolites during pregnancy, as well as their role on advanced maternal age, prenatal nutrition, and metabolic risk of the offspring.

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Excessive Maternal Orange Intake - A Reversible Etiology of Fetal Premature Ductus Arteriosus Constriction: A Case Report

Cited by 8 publications

References 10 publications

Fetal Ductus Arteriosus Premature Constriction

Fetal Ductus Arteriosus Premature Constriction

Foetal ductus arteriosus constriction unrelated to non-steroidal anti-Inflammatory drugs: a case report and literature review

The Role of Dietary Polyphenols in Pregnancy and Pregnancy-Related Disorders

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