Postnatal closure of ductus venosus in preterm infants ≤32 weeks

Fugelseth, Drude; Lindemann, Rolf; Liestøl, Knut; Kiserud, Torvid; Langslet, A

doi:10.1016/s0378-3782(98)00051-6

Cited by 36 publications

(34 citation statements)

References 19 publications

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“…Our results also show that the ductus venosus tends to close later in neonates of shorter gestation or lower birth weight. In a study of neonates of 32 weeks gestation by Fugelseth et al ,9 the ductus venosus had closed by day 8 in 40% and by day 18 in 88%—that is, in 50% of neonates by about day 8. With measurements every three to four days, Loberant et al 10 reported that the ductus venosus closed within 6–10 days in infants of gestational age 33–36 weeks, and within 10–14 days in those of gestational age 28–32 weeks.…”

Section: Discussionmentioning

confidence: 94%

Time of closure of ductus venosus in term and preterm neonates

Kondo

Itoh

Kunikata

et al. 2001

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Aim-To investigate the relation between gestational age, birth weight, and antenatal corticosteroid administration and the time of ductus venosus closure. Methods-Ninety eight neonates of 30-41 weeks gestational age were studied by daily ultrasonography until ductus venosus closure. Results-In neonates of 30-33 weeks gestational age, the ductus venosus closed at 6.0 (2.4)days (mean (SD)); in those of 34-36 weeks gestational age, it closed at 6.1 (2.8) days; and in those of 37-41 weeks gestational age, it closed at 4.2 (2.1) days. The eVect of antenatal administration of corticosteroids on the time of closure was also investigated in neonates of 30-34 weeks gestational age. Closure occurred by 5.5 (2.4) days in the group given corticosteroids compared with 7.5 (2.1) days in the remainder. Conclusions-The ductus venosus closed sooner after birth in neonates of greater gestational age or higher birth weight. Antenatal corticosteroid administration had a significant eVect in promoting closure. (Arch Dis Child Fetal Neonatal Ed 2001;85:F57-F59) Keywords: ductus venosus closure; antenatal corticosteroids; gestational age; birth weightThe adaptation of the respiratory, circulatory, endocrine, metabolic, and nervous systems from the intrauterine to the extrauterine environment must be accomplished dynamically and smoothly at birth. The adaptation of the postnatal circulatory system is the most abrupt and dynamic of these changes. There are three specific vascular shunts in the fetal period: the foramen ovale, which by closing separates the left and right heart systems; the ductus arteriosus, which separates the pulmonary and systemic circulation; the ductus venosus, which separates the hepatoportal and systemic circulation. The pathophysiology and mechanism of closure and the pharmacological manipulation of the ductus arteriosus have been studied in detail. The ductus venosus, on the other hand, has been the subject of very little study because it is regarded as having little pathophysiological significance. A functionally patent ductus venosus was found to shunt at least 25% of the total portal blood flow in 50% of lambs between the second and sixth days of life, 1 which is a level that cannot be ignored. Moreover, the early postnatal period is an unstable phase for the respiratory and circulatory systems and often a period of frequent drug treatment. In addition, if feeding is started from an early age, liver metabolism and other factors aVect ductus venosus patency, and clinically there is the possibility of deleterious eVects on the body from endogenous and exogenous toxic substances.The purpose of this study was to investigate the relation of gestational age and birth weight to the time of functional closure of the ductus venosus, as well as whether or not antenatal administration of corticosteroids aVects the time of closure. Materials and methodsThe subjects were 98 neonates of 30-41 weeks gestational age, who were in the Perinatal Center of the Ehime Prefecture Central Hospital between June 1995 and D...

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Section: Discussionmentioning

confidence: 94%

Time of closure of ductus venosus in term and preterm neonates

Kondo

Itoh

Kunikata

et al. 2001

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…No data are available in the living fetus to confirm this point. However, in the newborn it has been shown that prematurity is linked to delayed closure of the vessel (Fugelseth et al, 1998;Loberant et al, 1999;Kondo et al, 2001).…”

Section: Aso Adeagbo Et Al Endothelin and Prostaglandin In The Ducmentioning

confidence: 99%

“…While confirming the importance of extrinsic factors -resistance of the hepatic vascular district, magnitude of the umbilicocaval pressure gradient, blood viscosity -for the control of ductal flow (see Kiserud, 1999), this new line of investigation has yielded direct evidence, both in animals and humans, of an active tone regulation in the putative sphincter region as well as in the remainder of the vessel (Bellotti et al, 1998;Kiserud et al, 2000a). Coincidentally, it has demonstrated that ductus closure is delayed in preterm compared to term infants and, moreover, has ascertained that this sign of prematurity may subside after antenatal treatment with corticosteroids (Fugelseth et al, 1998;Loberant et al, 1999;Kondo et al, 2001). The latter observation is consistent with a gestation-linked maturation of local mechanism(s) that are amenable to upregulation.…”

Section: Introductionmentioning

confidence: 96%

Endothelin‐induced constriction of the ductus venosus in fetal sheep: developmental aspects and possible interaction with vasodilatory prostaglandin

Adeagbo

Kelsey

Coceani

2004

British J Pharmacology

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1 The ductus venosus is actively regulated in the fetus, but questions remain on the presence of a functional sphincter at its inlet. Using fetal sheep (0.6-0.7 gestation onwards), we have examined the morphology of the vessel and have also determined whether endothelin-1 (ET-1) qualifies as a natural constrictor being modulated by prostaglandins (PGs). 2 Masson's staining and a-actin immunohistochemistry showed a muscular, sphincter-like formation at the ductus inlet and a muscle layer within the wall of the vessel proper. This muscle cell component increased with age. 3 ET-1 contracted dose-dependently isolated sphincter and extrasphincter preparations of the ductus from term fetus. This ET-1 effect also occurred in the premature, but its threshold was higher. 4 BQ123 (1 mM) caused a rightward shift in the ET-1 dose-response curve, while indomethacin at a threshold concentration (28 nM) tended to have an opposite effect. 5 Big ET-1 also contracted the ductus sphincter but differed from ET-1 for its lesser potency and inhibition by phosphoramidon (50 mM). 6 The ductus sphincter (term and preterm) and extrasphincter (term) released 6-keto-PGF 1a (hence PGI 2 ) and, to a lesser degree, PGE 2 at rest and their release increased dose-dependently upon ET-1 treatment. Both basal and stimulated release was curtailed by endothelium removal. 7 BQ123 and phosphoramidon reduced slightly the contraction of ductus sphincter to indomethacin (2.8 mM). 8 We conclude that the ductus contains a contractile mechanism in the sphincter and extrasphincter regions. ET-1 lends itself to a role in the generation of contractile tone and its action may be modulated by prostaglandins.

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“…It has been speculated that levels of circulating hormones, particularly prostaglandins, may regulate shunt closure and timing (Fugelseth et al 1998). Babies born prematurely often have difficulty with the transition to normal postnatal circulation because they retain fetal circulatory patterns due to delayed shunt closure (Evans and Iyer 1994).…”

Section: Foramen Ovale → Fossa Ovalismentioning

confidence: 99%

Vestiges of the natural history of development: historical holdovers reveal the dynamic interaction between ontogeny and phylogeny

Werth

2014

Evo Edu Outreach

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Vestigial features of humans and other organisms are well known and have long been used as key evidence for evolution. Such features include not only anatomical structures but also physiological processes, biochemical reactions, and even behaviors. In addition to remnants of evolutionary change, traces of developmental change likewise exist, and it is important to distinguish embryonic remains from true evolutionary vestiges because people confuse evolutionary and developmental changes. To avoid confusion, the term vestige should be reserved for true evolutionary holdovers. This paper presents examples of developmental remnants, which often involve circulatory and reproductive alterations, and discusses numerous other retained or reappearing historical holdovers in ways that reveal the unfolding dynamic interaction between genotype and phenotype. These holdovers are useful in differentiating and relating concepts of phylogeny and ontogeny as well as revealing benefits of historical reasoning in understanding patterns and processes of organismal change.

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Postnatal closure of ductus venosus in preterm infants ≤32 weeks

Cited by 36 publications

References 19 publications

Time of closure of ductus venosus in term and preterm neonates

Time of closure of ductus venosus in term and preterm neonates

Endothelin‐induced constriction of the ductus venosus in fetal sheep: developmental aspects and possible interaction with vasodilatory prostaglandin

Vestiges of the natural history of development: historical holdovers reveal the dynamic interaction between ontogeny and phylogeny

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