{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:31:59Z","timestamp":1791869519818,"version":"4.3.4"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Bonn"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Prenatal severe Ebstein anomaly might be complicated by a circular shunt. In these cases, persistently elevated right atrial and venous pressure (due to severe tricuspid regurgitation) is complicated by a systemic ineffective blood shunt via a DA, resulting in diminished end-organ perfusion and acidosis, due to overall low cardiac output. Affected fetuses are at a significantly higher risk of intrauterine fetal demise. Reduction of ductal flow by prenatal treatment with nonsteroidal anti-inflammatory drugs has recently been described as a potential treatment option. However, published data are limited and management during the antenatal course is not well defined. We provide a literature review to propose a possible algorithm for prenatal assessment and initiation of treatment.<\/jats:p>","DOI":"10.1007\/s00404-025-07990-z","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T03:02:14Z","timestamp":1741748534000},"page":"25-35","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hemodynamic considerations for prenatal treatment of severe Ebstein anomaly with circular shunt based on two cases and review of the literature"],"prefix":"10.1007","volume":"312","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8302-3854","authenticated-orcid":false,"given":"Adeline","family":"Walter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Pl\u00f6ger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Recker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boulos","family":"Asfour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Mini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annegret","family":"Geipel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Gembruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Strizek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"7990_CR1","doi-asserted-by":"publisher","DOI":"10.3233\/NPM-230040","author":"FL Pe\u00f1a","year":"2024","unstructured":"Pe\u00f1a FL, Emanuelson TW, Todman SH et al (2024) Fetal circular shunt in Ebstein\u2019s anomaly and non-steroidal anti-inflammatory treatment. 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As the Ethics Committee of the University of Bonn does not request formal approval for an anonymized retrospective analysis of clinical data, ethical consent was not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from every patient participating in this review for clinical data collection, analysis, and the use of those data for research.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Consent for publication was obtained from every patient participating in this review.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}