ANEURYSM OF THE DUCTUS ARTERIOSUS WITH HEMODYNAMIC CHANGES IN THE FETAL HEART

A CASE REPORT

Abstract

INTRODUCTION: Ductus arteriosus aneurysm is a rare finding in fetal life, probably because it is not routinely investigated in the third trimester of pregnancy. CASE REPORT: Patient 41 years old, second pregnancy, with no cardiac abnormality on fetal echocardiography during first and second trimester screening. In the third trimester, at 36 weeks, a saccular image was observed with turbulent flow in a section of three vessels and trachea in the ductus arteriosus, enlargement of the right heart chambers, ductus venosus with overload in the right atrium and mild polyhydramnios. In the following week, the patient reported a marked decrease in fetal movement and the fetal echocardiogram showed greater enlargement of the right chambers and marked polyhydramnios. Altered fetal biophysical profile with absence of fetal movements, respiratory movement and decreased tone. Venous Doppler with signs of right cardiac overload. Patient underwent cesarean delivery without intercurrences. The newborn underwent an echocardiogram on the third day of life, which showed closure of the ductus arteriosus and resolution of the aneurysm. In outpatient follow-up. CONCLUSION: Ductus arteriosus aneurysms, although rare or poorly diagnosed, most evolve benignly after closure of the ductus arteriosus, however, there are complications such as spontaneous rupture, thromboembolism and neonatal death. Therefore, performing an ultrasound in the third trimester of pregnancy in order to rule out late fetal pathologies is of fundamental importance for the proper monitoring of the newborn.