The Significance of Ductal Tortuosity in Late Gestation Fetuses with Normal Hearts: Is There a Relation to Ductal Flow Changes or Right Ventricular Functional Findings?

Nguyen CP, Michelfelder EC, Kreeger J, Jergel A, Ro SS

Journal ArticleAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

Ductal tortuosity in late-gestation fetuses with normal hearts was not associated with ductal Doppler measures or meaningful right ventricular functional changes.

What was studied

Retrospective evaluation of 80 fetal echocardiograms at 32 weeks or more with a tortuous ductus arteriosus, graded by ductal angle and number of bends, relating grade to ductal Doppler flow and RV function.

Key findings

Most had moderate (47.5%) or mild (40%) tortuosity; mean gestational age 34.9 weeks
Mean ductal PSV was 1.6 m/s and 45% had elevated PSV for gestational age; 95% had normal or high PI
Tortuosity was not associated with PSV or PI
Moderate tortuosity had a higher RV/LV size ratio than mild

Clinical relevance

A tortuous ductus is a common finding on late fetal echo; this suggests it may not by itself indicate abnormal ductal flow or RV dysfunction.

Who should care

Neonatology

Limitations

Small retrospective single-group sample without outcome follow-up or a comparison group without tortuosity.

Isolated ductal tortuosity with normal cardiac anatomy may be a variant rather than a sign of ductal constriction, though larger studies are needed.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

OBJECTIVE

The objective of this study is to investigate whether tortuous ductus arteriosus (DA) is associated with changes in ductal Doppler flow or right ventricular (RV) functional findings in late gestation, structurally normal heart fetuses.

STUDY DESIGN

Fetuses ≥ 32 weeks' gestation with tortuous DA from January 2016 to November 2023 were evaluated. Using the narrowest ductal angle and number of ductal bends, DA tortuosity grade was assigned as mild (one bend, ≥ 90 degrees), moderate (one bend, < 90 degrees), and severe (≥2 bends). DA flow included peak systolic flow velocity (PSV) and pulsatility index (PI). RV functional markers included tricuspid regurgitation, RV to left ventricle (LV) (RV/LV) size ratio, RV function, and venous Dopplers.

RESULTS

Eighty fetal echocardiograms were evaluated. The mean gestational age (GA) was 34.9 weeks. The majority of our cohort had either moderate tortuosity (47.5%) or mild tortuosity (40%) grade. The mean PSV was 1.6 m/s and 45% of subjects had elevated PSV for GA. The mean PI was 2.4, with 95% of our cohort having a normal or high PI for GA. DA tortuosity was not associated with DA PSV or PI for GA. Compared with the group with mild tortuosity grade, the moderate group had significantly higher mean RV/LV size ratio and lower mean narrowest ductal tortuosity angle.

CONCLUSION

Variable ductal tortuosity is seen in late gestation fetuses with normal cardiac anatomy. The majority of our cohort had elevated PSV for GA but with a normal or high PI for GA. The degree of ductal tortuosity was not associated with PSV or significant RV functional changes.

KEY POINTS

· Variable ductal tortuosity is seen in late gestation fetuses with normal hearts.. · The majority of our fetuses had elevated PSV but with a normal or high PI.. · Ductal tortuosity does not correlate with PSV, PI, or significant changes in right ventricular functional findings..

DOI

10.1055/a-2935-6547

PMID

42580777

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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