Ductus arteriosus - wikipedia Ductus arteriosus Ductus arteriosus Plan of the fetal circulation. ( `` Ductus arteriosus '' visible at upper right. ) Heart cross-section with PDA Details Precursor aortic arch 6 Source pulmonary artery Branches descending aorta Vein ductus venosus Identifiers Latin Ductus arteriosus MeSH D004373 TE E5. 11.2. 1.2. 0.17 FMA 79871 Anatomical terminology ( edit on Wikidata ) In the developing fetus, the ductus arteriosus, also called the ductus Botalli, is a blood vessel connecting the main pulmonary artery to the proximal descending aorta. It allows most of the blood from the right ventricle to bypass the fetus 's fluid - filled non-functioning lungs. Upon closure at birth, it becomes the ligamentum arteriosum. There are two other fetal shunts, the ductus venosus and the foramen ovale. Contents 1 Development and structure 2 Clinical significance 2.1 Patent ductus arteriosus 3 See also 4 References 5 External links Development and structure The ductus arteriosus is formed from the left 6th aortic arch during embryonic development and attaches to the final part of the aortic arch ( the isthmus of aorta ) and the first part of the pulmonary artery Clinical significance Patent ductus arteriosus Main article : Patent ductus arteriosus Failure of the DA to close after birth results in a condition called patent ductus arteriosus and the generation of a left - to - right shunt. If left uncorrected, patency leads to pulmonary hypertension and possibly congestive heart failure and cardiac arrhythmias. The E series of prostaglandins are responsible for maintaining the patency of the DA ( by dilation of vascular smooth muscle ) throughout the fetal period. Prostaglandin E2 ( PGE ), produced by both the placenta and the DA itself, is the most potent of the E prostaglandins, but prostaglandin E1 ( PGE ) also has a role in keeping the DA open. PGE and PGE keep the DA open via involvement of specific PGE - sensitive receptors ( such as EP4 and EP2 ). EP4 is the major receptor associated with PGE - induced dilation of the DA and can be found across the DA in smooth muscle cells. Immediately after birth, the levels of both PGE and the EP4 receptors reduce significantly, allowing for closure of the DA and establishment of normal postnatal circulation. According to one study, median DA persistency times were 27.42 and 45.10 h after birth in boys and girls, respectively. A statistically significant sex difference was observed ( p < 0.0001 ). Additionally, significant time differences were observed between vaginal and scheduled caesarean deliveries, at 26.97 and 28.93 h, respectively ( p = 0.0245 ). In some types of congenital heart defect ( e.g., transposition of the great arteries ), prostaglandins may be administered to maintain DA patency, allowing for the continual circulation and oxygenation of blood, until surgery can be performed. DA closure may be induced by administration of nonsteroidal anti-inflammatory drugs ( NSAIDs ), which inhibit prostaglandin production. The most common NSAID that is used to force DA closure is Indomethacin ( a prostaglandin synthetase inhibitor ), which can be administered after birth ( used in first week of life ). However, in the presence of a congenital defect with impaired lung perfusion ( e.g. Pulmonary stenosis and left - to - right shunt through the ductus ), it may be advisable to improve oxygenation by maintaining the ductus open with prostaglandin treatment. However, such treatments are ineffective in an abnormal ductus. Persistence of the ductus may be associated with other abnormalities, and is much more common in females. By inhibiting PGE formation, EP4 receptor activation will decrease and normal circulation can begin. NSAIDs taken late in pregnancy can cross the placenta and lead to premature closure of the DA in the fetus. In this case, exogenous PDE can be administered to reverse the effects of the NSAIDs and maintain the patency of the DA for the remainder of the pregnancy. A patent ductus arteriosus affects approximately 4 % of infants with Down syndrome ( DS ). A failure to thrive is a very common sign of this condition. See also Ductus venosus This article uses anatomical terminology ; for an overview, see Anatomical terminology. References Jump up ^ Bamforth, Simon D. ; Chaudhry, Bill ; Bennett, Michael ; Wilson, Robert ; Mohun, Timothy J. ; Van Mierop, Lodewyk H.S. ; Henderson, Deborah J. ; Anderson, Robert H. ( 2013 - 03 - 01 ). `` Clarification of the identity of the mammalian fifth pharyngeal arch artery ''. Clinical Anatomy. 26 ( 2 ) : 173 -- 182. doi : 10.1002 / ca. 22101. ISSN 1098 - 2353. PMID 22623372. Jump up ^ Srichai, editors, David P. Naidich... ( et al. ) ; contributing author, Monvadi B. ( 2007 ). Computed tomography and magnetic resonance of the thorax ( 4th ed. ). Philadelphia : Wolters Kluwer / Lippincott Williams & Wilkins. p. 100. ISBN 9780781757652. CS1 maint : Extra text : authors list ( link ) Jump up ^ Lucas, A ( 1978 ). `` PROSTAGLANDINS IN PATENT DUCTUS ARTERIOSUS ''. The Lancet. 312 ( 8096 ) : 937 -- 938. doi : 10.1016 / S0140 - 6736 ( 78 ) 91648 - 3. ISSN 0140 - 6736. ^ Jump up to : Olley, P.M. ; Conceani F. ( 1981 ). `` Prostaglandins and the Ductus Arteriosus ''. Annual Review of Medicine. 32 ( 1 ) : 375 -- 385. doi : 10.1146 / annurev. me. 32.020181. 002111. Jump up ^ Bouayad A, Kajino H, Waleh N, Fouron JC, Andelfinger G, Varma DR, Skoll A, Vazquez A, Gobeil F, Clyman RI, Chemtob S ( 2001 ). `` Characterization of PGE2 receptors in fetal and newborn lamb ductus arteriosus ''. Am. J. Physiol. Heart Circ. Physiol. 280 ( 5 ) : H2342 -- 9. doi : 10.1152 / ajpheart. 2001.280. 5. H2342. PMID 11299240. ^ Jump up to : Gruzdeva, A ; Nguyena, M. ; Kovarovob, M. ; Koller, B ( March 2012 ). `` PGE2 through the EP4 receptor controls smooth muscle gene expression patterns in the ductus arteriosus critical for remodeling at birth ''. Prostaglandins and other Lipid Mediators. 94 ( 3 ) : 109 -- 119. doi : 10.1016 / j. prostaglandins. 2012.02. 001. PMC 3312001. Jump up ^ Nagasawa, Hiroyuki ; Hamada, Chikuma ; Wakabayashi, Masashi ; Nakagawa, Yuki ; Nomura, Satoshi ; Kohno, Yoshinori ( 2016 - 05 - 01 ). `` Time to spontaneous ductus arteriosus closure in full - term neonates ''. Open Heart. 3 ( 1 ) : e000413. doi : 10.1136 / openhrt - 2016 - 000413. ISSN 2053 - 3624. Jump up ^ `` Congenital heart defects : Prostaglandins and prostaglandin inhibitors ''. Healthwise. My Health Alberta. Jump up ^ Anonucci, R ; Zaffanello, M. ; Puxeddu, E. ; Porcella, A. ; Cuzzolin, L. ; Pilloni, M. ; Fanos, V. ( 2012 ). `` Use of non-steroidal anti-inflammatory drugs in pregnancy : impact on the fetus and newborn ''. Current Drug Metabolism. 13 ( 4 ) : 474 -- 490. doi : 10.2174 / 138920012800166607. Jump up ^ Pritchard & Korf. `` Medical Genetics at a Glance ''. Blackwell Publishing. 2010. p63. External links Circulatory changes at birth at berkeley.edu hide Development of the circulatory system Heart Tubular heart Truncus arteriosus Bulbus cordis Primitive ventricle Primitive atrium Sinus venosus Chamber formation Atrioventricular Primary interventricular foramen Endocardial cushions Septum intermedium Atrioventricular canal Atrial Septum primum Foramen secundum Primary interatrial foramen Septum secundum Foramen ovale Other Aorticopulmonary septum Protein signalling in heart development Vessels Arteries Dorsal aorta Aortic arches Aortic sac Veins Anterior cardinal vein Posterior cardinal vein Common cardinal veins Lymph vessels Lymph sacs Extraembryonic hemangiogenesis Blood islands Chorion Connecting stalk Yolk sac Placenta Fetal circulation umbilical cord : Umbilical vein → Ductus venosus → Inferior vena cava → Heart → Pulmonary artery → Ductus arteriosus → Aorta → Umbilical artery yolk sac : Vitelline veins Vitelline arteries Retrieved from `` https://en.wikipedia.org/w/index.php?title=Ductus_arteriosus&oldid=843216865 '' Categories : Embryology of cardiovascular system Hidden categories : Pages with unresolved properties CS1 maint : Extra text : authors list Anatomy NAV infobox with use of other NAV parameters Talk Contents About Wikipedia Беларуская Čeština Deutsch Español Français Galego Italiano עברית Nederlands 日本 語 Norsk Norsk nynorsk Oʻzbekcha / ўзбекча Polski Português Русский Српски / srpski Svenska Українська 中文 12 more Edit links This page was last edited on 27 May 2018, at 17 : 58. 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Question: in the fetus the ductus arteriosus carries blood from
Answer: the main pulmonary artery to the proximal descending aorta