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Cole LK, Sparagna GC, Dolinsky VW, Hatch GM. Altered cardiolipin metabolism is associated with cardiac mitochondrial dysfunction in pulmonary vascular remodeled perinatal rat pups. PLoS One 2022; 17:e0263520. [PMID: 35143544 PMCID: PMC8830687 DOI: 10.1371/journal.pone.0263520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/21/2022] [Indexed: 12/24/2022] Open
Abstract
Pulmonary vascular remodeling (PVR) in utero results in the development of heart failure. The alterations that occur in cardiac lipid and mitochondrial bioenergetics during the development of in utero PVR was unknown. In this study, PVR was induced in pups in utero by exposure of pregnant dams to indomethacin and hypoxia and cardiac lipids, echocardiographic function and cardiomyocyte mitochondrial function were subsequently examined. Perinatal rat pups with PVR exhibited elevated left and right cardiac ventricular internal dimensions and reduced ejection fraction and fractional shortening compared to controls. Cardiac myocytes from these pups exhibited increased glycolytic capacity and glycolytic reserve compared to controls. However, respiration with glucose as substrate was unaltered. Fatty acid oxidation and ATP-insensitive respiration were increased in isolated cardiac myocytes from these pups compared to controls indicating a mitochondrial dysfunction. Although abundance of mitochondrial respiratory chain complexes was unaltered, increased trilinoleoyl-lysocardiolipin levels in these pups was observed. A compensatory increase in both cardiolipin and phosphatidylethanolamine content were observed due to increased synthesis of these phospholipids. These data indicate that alterations in cardiac cardiolipin and phospholipid metabolism in PVR rat pups is associated with the mitochondrial bioenergetic and cardiac functional defects observed in their hearts.
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Affiliation(s)
- Laura K. Cole
- Department of Pharmacology and Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Genevieve C. Sparagna
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado, United States of America
| | - Vernon W. Dolinsky
- Department of Pharmacology and Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Grant M. Hatch
- Department of Pharmacology and Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
- * E-mail:
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Dathe K, Frank J, Padberg S, Hultzsch S, Meixner K, Beck E, Meister R, Schaefer C. Negligible risk of prenatal ductus arteriosus closure or fetal renal impairment after third‐trimester paracetamol use: evaluation of the German Embryotox cohort. BJOG 2019; 126:1560-1567. [DOI: 10.1111/1471-0528.15872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2019] [Indexed: 11/28/2022]
Affiliation(s)
- K Dathe
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - J Frank
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - S Padberg
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - S Hultzsch
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - K Meixner
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - E Beck
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
| | - R Meister
- Department of Mathematics Beuth Hochschule für Technik—University of Applied Sciences Berlin Germany
| | - C Schaefer
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institut für Klinische Pharmakologie und Toxikologie Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie Berlin Germany
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Risk estimation of fetal adverse effects after short-term second trimester exposure to non-steroidal anti-inflammatory drugs: a literature review. Eur J Clin Pharmacol 2019; 75:1347-1353. [PMID: 31273431 DOI: 10.1007/s00228-019-02712-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Non-steroidal anti-inflammatory drugs (NSAIDs) are not recommended in the 3rd trimester of pregnancy due to known fetal adverse effects in an advanced gestational age. This investigation was performed to assess whether there is a significant risk of NSAIDs being used as an analgesic or antipyretic medication in the 2nd trimester. METHODS A systematic search for publications reporting 2nd trimester NSAID exposure was performed in MEDLINE. The search focused on case descriptions reporting defined adverse effects including prenatal ductus arteriosus constriction, oligohydramnios, neonatal renal failure, and primary pulmonary hypertension. Original articles published until February 2018 were considered for evaluation. RESULTS Out of 681 identified publications, 26 included relevant information on the defined adverse effects. Among these publications, premature labor was the major reason for 2nd trimester indomethacin treatment while other clinical indications and other NSAIDs were underrepresented. Narrowing or closure of the ductus arteriosus in the 2nd trimester was described in 33 fetuses. Only eight publications reported adverse effects after less than 7-day exposure during the 2nd trimester. CONCLUSIONS Based on these results, short-term use of NSAIDs as analgesics or antipyretics in the 2nd trimester does not appear to pose a substantial risk for fetal adverse effects. Long-term use in the late 2nd trimester, however, should always be monitored.
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Pedra SRFF, Zielinsky P, Binotto CN, Martins CN, Fonseca ESVBD, Guimarães ICB, Corrêa IVDS, Pedrosa KLM, Lopes LM, Nicoloso LHS, Barberato MFA, Zamith MM. Brazilian Fetal Cardiology Guidelines - 2019. Arq Bras Cardiol 2019; 112:600-648. [PMID: 31188968 PMCID: PMC6555576 DOI: 10.5935/abc.20190075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Simone R F Fontes Pedra
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil.,Hospital do Coração (HCor), São Paulo, SP - Brazil
| | - Paulo Zielinsky
- Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, RS - Brazil
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Garcia-Contreras C, Vazquez-Gomez M, Barbero A, Pesantez JL, Zinellu A, Berlinguer F, Gonzalez-Añover P, Gonzalez J, Encinas T, Torres-Rovira L, Nuñez Y, Ballesteros J, Ayuso M, Astiz S, Isabel B, Ovilo C, Gonzalez-Bulnes A. Polyphenols and IUGR Pregnancies: Effects of Maternal Hydroxytyrosol Supplementation on Placental Gene Expression and Fetal Antioxidant Status, DNA-Methylation and Phenotype. Int J Mol Sci 2019; 20:ijms20051187. [PMID: 30857182 PMCID: PMC6429121 DOI: 10.3390/ijms20051187] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/27/2019] [Accepted: 03/05/2019] [Indexed: 12/14/2022] Open
Abstract
The use of polyphenols is a promising strategy for preventing or alleviating intrauterine growth restriction (IUGR) because polyphenol supplementation increases plasma antioxidant capacity and improves oxidative stress at the feto-placental unit; which are recognized as main issues in IUGR. However, there is a scarcity of experimental data on both realistic benefits and potential hazards of polyphenol supplementation during gestation. Hence, we aimed to use a swine model of IUGR pregnancy to determine possible effects of maternal supplementation with polyphenols (hydroxytyrosol) on placental expression of genes involved in antioxidant homeostasis, vascularization and fetal growth and thus on antioxidant status, DNA-methylation and phenotypic traits (morphology and homeostasis) of the fetus. Hydroxytyrosol improves placental gene expression and fetal antioxidant status and glucose metabolism in a sex-dependent manner, in which males were favored in spite of developmental failures. Concomitantly, hydroxytyrosol prevented hypomethylation of DNA associated with oxidative stress. Finally, no major deleterious effects of hydroxytyrosol supplementation on constriction of the ductus arteriosus, a possible secondary effect of polyphenols during pregnancy, were found.
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Affiliation(s)
- Consolación Garcia-Contreras
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
| | - Marta Vazquez-Gomez
- Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), Ciudad Universitaria s/n, 28040 Madrid, Spain.
| | - Alicia Barbero
- Diagnostic Imaging Service, Universidad Alfonso X El Sabio, 28691 Madrid, Spain.
| | - José Luis Pesantez
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
- School of Veterinary Medicine and Zootechnics, Faculty of Agricultural Sciences, University of Cuenca, Avda. Doce de Octubre, 010220 Cuenca, Ecuador.
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy.
| | - Fiammetta Berlinguer
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy.
| | - Pedro Gonzalez-Añover
- Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), Ciudad Universitaria s/n, 28040 Madrid, Spain.
| | - Jorge Gonzalez
- Micros Veterinaria, Campus de Vegazana, 24007 Leon, Spain.
| | - Teresa Encinas
- Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), Ciudad Universitaria s/n, 28040 Madrid, Spain.
| | - Laura Torres-Rovira
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
| | - Yolanda Nuñez
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
| | - Jaime Ballesteros
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
| | - Miriam Ayuso
- Laboratory of Applied Veterinary Morphology, Department of Veterinary Sciences, Faculty of Biomedical, Pharmaceutical and Veterinary Sciences, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Susana Astiz
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
| | - Beatriz Isabel
- Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), Ciudad Universitaria s/n, 28040 Madrid, Spain.
| | - Cristina Ovilo
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
| | - Antonio Gonzalez-Bulnes
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Ctra. de La Coruña Km. 7,5, 28040 Madrid, Spain.
- Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), Ciudad Universitaria s/n, 28040 Madrid, Spain.
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Gewillig M, Brown SC, Roggen M, Eyskens B, Heying R, Givron P, Cools B, de Catte L. Dysfunction of the foetal arterial duct results in a wide spectrum of cardiovascular pathology. Acta Cardiol 2017; 72:625-635. [PMID: 28745124 DOI: 10.1080/00015385.2017.1314876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Foetal ductal problems may have various cardiopulmonary consequences. This study aimed to identify the spectrum of ductus arteriosus (DA) dysfunction (closure, constriction, kinking, aneurysm and thrombosis) and the resultant clinical and echocardiographic presentation in foetuses and neonates. METHODS AND RESULTS This is a retrospective analysis of serial pre- and post-natal data of 27 cases of foetal ductal dysfunction diagnosed at a median gestational age of 33 weeks (range 20-39). The most common abnormalities observed were premature closure of the DA in 56% (15/27) and constriction in 29% (8/27). Right ventricular hypertrophy was present in 75% (n = 11/15) of foetuses with premature DA closure, while ventricular dilation (4/7, 57%) was a more common feature in foetuses with ductal constriction. After birth, 63% (17/27) of new borns presented with cyanosis and pulmonary hypertension that required active treatment. Three infants died after birth. Abnormalities resolved spontaneously after birth in about 50% of patients. In some children, pulmonary valve stenosis and regurgitation was progressive and required further treatment. CONCLUSIONS An abnormal right heart on foetal four-chamber ultrasound view should alert the sonographer to the possible presence of foetal ductal dysfunction. Ductal occlusion, transient or fixed constriction, kinking and aneurysm formation are associated with foetal cardiopulmonary sequelae. Symptoms and pathology is probably related to the type, foetal age, rapidity of progression and duration of intrauterine ductal dysfunction. Correspondingly, clinical outcomes vary ranging from little or no symptoms to severe respiratory distress and even foetal or neonatal death.
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Affiliation(s)
- Marc Gewillig
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Stephen C. Brown
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
- Department of Pediatric Cardiology, University of the Free State, Bloemfontein, South Africa
| | - Mieke Roggen
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Benedicte Eyskens
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Ruth Heying
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Patrice Givron
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Bjorn Cools
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Luc de Catte
- Department of Fetal and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
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Abstract
BACKGROUND A number of case reports show various outcomes of premature closure of the ductus arteriosus in utero, including persistent pulmonary hypertension of the newborn and fetal or neonatal death; however, no study clarifies the clinical observations that are related to their prognoses. We aimed to clarify the prognostic factors of intrauterine ductal closure by a systematic literature review. Data sources We searched PubMed database (1975-2014) to identify case reports and studies on intrauterine closure of the ductus arteriosus, including maternal, fetal, and neonatal clinical information and their prognoses. RESULTS We analysed the data of 116 patients from 39 articles. Of these, 12 (10.3%) died after birth or in utero. Fetal or neonatal death was significantly correlated with fetal hydrops (odds ratio=39.6, 95% confidence interval=4.6-47.8) and complete closure of the ductus arteriosus (odds ratio=5.5, 95% confidence interval=1.2-15.1). Persistent pulmonary hypertension was observed in 33 cases (28.4%), and was also correlated with fetal hydrops (odds ratio=4.2, 95% confidence interval=1.3-4.6) and complete closure of the ductus arteriosus (odds ratio=5.5, 95% confidence interval=1.6-6.0). Interestingly, maternal drug administration was not correlated with the risk of death and persistent pulmonary hypertension. CONCLUSIONS Fetal hydrops and complete ductal closure are significant risk factors for both death and persistent pulmonary hypertension. Cardiac or neurological prognoses could be favourable if the patients overcome right heart failure during the perinatal period.
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Kent AL, Koina ME, Gubhaju L, Cullen-McEwen LA, Bertram JF, Lynnhtun J, Shadbolt B, Falk MC, Dahlstrom JE. Indomethacin administered early in the postnatal period results in reduced glomerular number in the adult rat. Am J Physiol Renal Physiol 2014; 307:F1105-10. [PMID: 25186294 DOI: 10.1152/ajprenal.00328.2014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Indomethacin and ibuprofen are administered to close a patent ductus arteriosus (PDA) during active glomerulogenesis. Light and electron microscopic glomerular changes with no change in glomerular number were seen following indomethacin and ibuprofen treatment during glomerulogenesis at 14 days after birth in a neonatal rat model. This present study aimed to determine whether longstanding renal structural changes are present at 30 days and 6 mo (equivalent to human adulthood). Rat pups were administered indomethacin or ibuprofen antenatally on days 18-20 (0.5 mg·kg(-1)·dose(-1) indomethacin; 10 mg·kg(-1)·dose(-1) ibuprofen) or postnatally intraperitoneally from day 1 to 3 or day 1 to 5 (0.2 mg·kg(-1)·dose(-1) indomethacin; 10 mg·kg(-1)·dose(-1) ibuprofen). Control groups received no treatment or normal saline intraperitoneally. Pups were killed at 30 days of age and 6 mo of age. Tissue blocks from right kidneys were prepared for light and electron microscopic examination, while total glomerular number was determined in left kidneys using unbiased stereology. Eight pups were included in each group from 14 maternal rats. At 30 days and 6 mo, there were persistent electron microscopy abnormalities of the glomerular basement membrane in those receiving postnatal indomethacin and ibuprofen. There were no significant light microscopy findings at 30 days or 6 mo. At 6 mo, there were significantly fewer glomeruli in those receiving postnatal indomethacin but not ibuprofen (P = 0.003). In conclusion, indomethacin administered during glomerulogenesis appears to reduce the number of glomeruli in adulthood. Alternative options for closing a PDA should be considered including ibuprofen as well as emerging therapies such as paracetamol.
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Affiliation(s)
- A L Kent
- Department of Neonatology, Canberra Hospital, Woden, ACT, Australia; Australian National University Medical School, Canberra, ACT, Australia
| | - M E Koina
- Department of Anatomical Pathology, Canberra Hospital, Woden, ACT, Australia
| | - L Gubhaju
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia; and
| | - L A Cullen-McEwen
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia; and
| | - J F Bertram
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia; and
| | - J Lynnhtun
- Department of Anatomical Pathology, Canberra Hospital, Woden, ACT, Australia
| | - B Shadbolt
- Clinical Epidemiology Unit, Canberra Hospital, Woden, ACT, Australia; Australian National University Medical School, Canberra, ACT, Australia
| | - M C Falk
- Department of Renal Medicine, Canberra Hospital, Woden, ACT, Australia; Australian National University Medical School, Canberra, ACT, Australia
| | - J E Dahlstrom
- Department of Anatomical Pathology, Canberra Hospital, Woden, ACT, Australia; Australian National University Medical School, Canberra, ACT, Australia
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Zielinsky P, Busato S. Prenatal effects of maternal consumption of polyphenol-rich foods in late pregnancy upon fetal ductus arteriosus. ACTA ACUST UNITED AC 2014; 99:256-74. [PMID: 24339037 PMCID: PMC4065350 DOI: 10.1002/bdrc.21051] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 10/24/2013] [Indexed: 12/13/2022]
Abstract
Fetal circulation has characteristic features, being morphologically and functionally different from extrauterine circulation. The ductus arteriosus plays a fundamental role in directing the blood flow to fetal inferior body parts. Basically, the ductus arteriosus directs 80-85% of the right ventricular output arising from the superior vena cava, coronary sinus, and a small part from the inferior vena cava to descending aorta. Its histological structure is made up predominantly by a thick muscular layer, differently from the aorta and the pulmonary artery, which increases with gestational age. The fibers have a circumferential orientation, especially at the external layers, facilitating and making effective ductal constriction. These factors may generate lumen alterations which may cause fetal and neonatal complications, such as heart failure, hydrops, neonatal pulmonary hypertension, and even death. Classically, maternal administration of indomethacin and/or other antiinflammatory drugs interfere in prostaglandins metabolism, causing ductal constriction. However, many cases of fetal ductal constriction, as well as of persistent neonatal pulmonary artery hypertension, remain without an established etiology, being referred as "idiopathic." In recent years, a growing body of evidence has shown that herbs, fruits, nuts, and a wide diversity of substances commonly used in daily diets have definitive effects upon the metabolic pathway of inflammation, with consequent inhibition of prostaglandins synthesis. This antiinflammatory action, especially of polyphenols, when ingested during the third trimester of pregnancy, may influence the dynamics of fetal ductus arteriosus flow. The goal of this review is to present these new observations and findings, which may influence dietary orientation during pregnancy.
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Affiliation(s)
- Paulo Zielinsky
- are from the Fetal Cardiology Unit, Institute of Cardiology, Porto Alegre, Brazil
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Zielinsky P, Piccoli AL, Manica JLL, Nicoloso LHS. New insights on fetal ductal constriction: role of maternal ingestion of polyphenol-rich foods. Expert Rev Cardiovasc Ther 2014; 8:291-8. [DOI: 10.1586/erc.09.174] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kent AL, Jyoti R, Robertson C, Gonsalves L, Meskell S, Shadbolt B, Falk MC. Does extreme prematurity affect kidney volume at term corrected age? J Matern Fetal Neonatal Med 2009; 22:435-8. [DOI: 10.1080/14767050802692102] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Chacón Aguilar R, Menéndez Hernando C, Chimenti Camacho P, Franco Sánchez ML, Sánchez Luna M. [Persistent pulmonary hypertension of the newborn following ingestion of nonsteroidal anti-inflammatory drugs during pregnancy]. An Pediatr (Barc) 2008; 68:357-60. [PMID: 18394380 DOI: 10.1157/13117706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Nonsteroidal anti-inflammatory drugs induce the inhibition of prostaglandin synthesis, which can cause constriction of the fetal ductus arteriosus in the pregnancy. We report two cases of antenatal closure of ductus arteriosus with severe pulmonary hypertension following maternal ingestion of nonsteroidal anti-inflammatory drugs (niflumic acid and acetylsalicylic acid) in the last days before delivery. To our knowledge, this is only the second case in literature describing antenatal closure of ductus arteriosus after the administration of niflúmic acid. Prescription of nonsteroidal anti-inflammatory drugs must be avoided during pregnancy. Fetal echocardiography must be monitored in those women treated with nonsteroidal anti-inflammatory drugs.
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Affiliation(s)
- R Chacón Aguilar
- Servicio de Neonatología. Departamento de Pediatría. Hospital General Universitario Gregorio Marañón. Madrid. España.
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Kent AL, Maxwell LE, Koina ME, Falk MC, Willenborg D, Dahlstrom JE. Renal glomeruli and tubular injury following indomethacin, ibuprofen, and gentamicin exposure in a neonatal rat model. Pediatr Res 2007; 62:307-12. [PMID: 17622959 DOI: 10.1203/pdr.0b013e318123f6e3] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Indomethacin, ibuprofen, and gentamicin are commonly administered to neonates between 24 and 28 wk gestation when glomerulogenesis is still occurring. Indomethacin is known to cause renal failure in up to 25% of infants treated. Possible morphologic effects of these drugs are largely unknown. The purpose of this study was to determine the type of renal changes found on light (LM) and electron microscopy (EM) following administration of indomethacin, ibuprofen, and gentamicin in a neonatal rat model. Rat pups were exposed to indomethacin or ibuprofen and/or gentamicin antenatally for 5 d before birth or postnatally for 5 d from d 1 of life. Pups were killed at 14 d of age. LM examination in all indomethacin- and ibuprofen-treated pups both antenatally and postnatally showed vacuolization of the epithelial proximal tubules, interstitial edema, intratubular protein deposition but no significant glomerular changes. EM examination showed pleomorphic mitochondria and loss of microvilli in the tubules. The glomeruli showed extensive foot process effacement and irregularities of the glomerular basement membrane. EM changes were most marked in pups treated antenatally with ibuprofen, and indomethacin with gentamicin postnatally. Indomethacin, ibuprofen, and gentamicin cause significant change in glomerular and tubular structure in the neonatal rat model.
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Affiliation(s)
- Alison L Kent
- Department of Neonatology, The Canberra Hospital, Woden, Australian Capital Territory 2606, Australia.
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