Excessive Maternal Orange Intake - A Reversible Etiology of Fetal Premature Ductus Arteriosus Constriction: A Case Report

Ductus arteriosus (DA) is a crucial element in the fetal circulation. Therefore, premature constriction of DA during the third trimester can have hazardous complications such as right ventricular dysfunction, fetal heart failure, hydrops, and even in utero demise. Normally, premature constriction is prevented by a balance between prostaglandin E2 and fetal oxygenation. Thus, drugs with antiprostaglandin effects are well-known causes for fetal DA constriction. A similar effect was discovered in eating polyphenol-rich food. Here, we report a case of early-detected fetal DA constriction due to a high maternal ingestion of fresh oranges, which are known to be rich in polyphenols. This effect was totally reversed 2 weeks after eliminating oranges from the maternal diet. From the current report, it is concluded that restrictions in the maternal diet regarding polyphenol-rich foods such as oranges can be considered during the third trimester to prevent the harmful effect on DA.