{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T01:56:18Z","timestamp":1779933378998,"version":"3.53.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,4,27]],"date-time":"2015-04-27T00:00:00Z","timestamp":1430092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Intact atrial septum or highly restrictive inter\u2010atrial communication (I\/HRAS) combined with either severe aortic stenosis (SAS) or hypoplastic left heart syndrome (HLHS), respectively, is associated with adverse outcome. This study focusses on changes in alveolo\u2010septal lung parenchyma due to increased left atrial pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In a retrospective cross\u2010sectional autoptic study, we investigated fetal\/neonatal lung specimens of 18 patients with SAS\/HLHS with I\/HRAS, 11 patients with SAS\/HLHS and unrestrictive inter\u2010atrial communications and 18 controls. Pulmonary maturation was investigated by means of morphometric and immunohistochemical analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a comparison of all three groups, alveolo\u2010capillary membrane maturation was significantly disturbed in I\/HRAS fetuses from week 23 of pregnancy on. I\/HRAS lungs showed angiomatoid hyper\u2010capillarisation and significantly wider inter\u2010airspace mesenchyme. Differences in width ranged between 34.58\u2009\u00b5m (95% CI: 11.41\u201357.75\u2009\u00b5m) and 46.74\u2009\u00b5m (95% CI: 13.97\u201379.50\u2009\u00b5m) in the second and third trimesters. In I\/HRAS infants with HLHS, inter\u2010airspace mesenchymal diameters steadily normalised with age; however, significant fibroelastosis of alveolar septae developed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fetal lung maturation with respect to alveolo\u2010capillary membrane formation is severely disordered in patients with SAS\/HLHS with I\/HRAS. Our findings indicate that, from a morphological point of view, timing of fetal invention in fetuses with I\/HRAS should be fixed within the second trimester of pregnancy. \u00a9 2015 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.4559","type":"journal-article","created":{"date-parts":[[2015,1,19]],"date-time":"2015-01-19T14:29:14Z","timestamp":1421677754000},"page":"463-470","source":"Crossref","is-referenced-by-count":23,"title":["Left ventricular obstruction with restrictive inter\u2010atrial communication leads to retardation in fetal lung maturation"],"prefix":"10.1002","volume":"35","author":[{"given":"Diane","family":"Goltz","sequence":"first","affiliation":[{"name":"Department of Pathology University Hospital of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Marc","family":"Lunkenheimer","sequence":"additional","affiliation":[{"name":"Department of Pathology University Hospital of Bonn  Bonn 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