Patency of the ductus arteriosus is critical in maintaining fetal circulation, and premature closure is associated with fetal and early neonatal death. We present 2 cases of sudden demise in the delivery room associated with atypical ductal anatomy with obstruction due to kinking and intraluminal intimal ridges. Shepherd hook anomaly of the ductus arteriosus may represent a new congenital heart lesion associated with poor fetal outcome.
KohlerHG. Premature closure of the ductus arteriosus (P.C.D.A.): a possible cause of intrauterine circulatory failure. Early Hum Dev. 1978;2:15–23.
2.
HarlassFEDuffPBradyKReadJ. Hydrops fetalis and premature closure of the ductus arteriosus: a review. Obstet Gynecol Surv. 1989;44:541–543.
3.
BeckerAEBeckerMJWagenvoortCA. Premature contraction of the ductus arteriosus: a cause of foetal death. J Pathol. 1977;121:187–191.
4.
DowningGJThibeaultDW. Pulmonary vasculature changes associated with idiopathic closure of the ductus arteriosus and hydrops fetalis. Ped Cardiol. 1994;15:71–75.
5.
MielkeGBendaN. Reference ranges for two-dimensional echocardiographic examination of the fetal ductus arteriosus. Ultrasound Obstet Gynecol. 2000;15:219–225.
6.
TrevettTNJrCottonJ. Idiopathic constriction of the fetal ductus arteriosus. Ultrasound Obstet Gynecol. 2004;23:517–519.
7.
BensonCBBrownDLDoubiletPMDiSalvoDNLaingFCFratesMC. Increasing curvature of the normal fetal ductus arteriosus with advancing gestational age. Ultrasound Obstet Gynecol. 1995;5:95–97.
8.
MielkeGPeukertUKrappMSchneider-PungsJGembruchU. Fetal and transient neonatal right heart dilatation with severe tricuspid valve insufficiency in association with abnormally S-shaped kinking of the ductus arteriosus. Ultrasound Obstet Gynecol. 1995;5:338–341.
9.
KimHSSohnSParkMYChoiJY. Coexistence of ductal constriction and closure of the foramen ovale in utero. Ped Cardiol. 2003;24:588–590.
