October 31st, 2014

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Title:
Possible Association Between Maternal Lithium Therapy and Premature Closure of the Arterial Duct: A Case Report
Authors:  Dana L. Ellis, M.D., Vitor Guerra, M.D., Ph.D., Gabriella Pridjian, M.D., and Michael R. Recto, M.D.
 
BACKGROUND: Frequent causes of premature ductal closure include spontaneous idiopathic closure in utero and maternal use of nonsteroidal anti-inflammatory drugs late in pregnancy.

CASE: We describe a case of a preterm infant born to a mother treated with lithium throughout pregnancy who presented with right-sided cardiac enlargement at 18 weeks’ gestation. Immediately following delivery, echocardiography demonstrated a small closing patent arterial duct.

CONCLUSION: We recommend that serial fetal echocardiography with emphasis on Doppler interrogation of the patent arterial duct be performed whenever a pregnant woman is taking lithium. The interrogation of the patent arterial duct is particularly important if right-sided chamber enlargement is noted at fetal sonography as this finding can be an early manifestation of premature ductal constriction.
Keywords:  congenital heart defect, lithium, patent ductus arteriosus, persistent pulmonary hypertension of newborn
   
   
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