Pulmonary Artery Stenosis Associated with Ductus Arteriosus Following Maternal Rubella

T HE most frequent cardiovascular anomaly following maternal rubella is patent ductus arteriosus.1-0; The majority of patients with typical signs of patent ductus arteriosus are treated surgically without special diagnostic studies such as cardiac catheterization and angiocardiography. In these individuals residual systolic murmurs may persist and are often attributed to mild pulmonary valvular stenosis. In many of these cases mild valvular pulmonic stenosis has been demonstrated by cardiac catheterization.7-9 Other cardiac malformations,)' 10 have been associated with maternal rubella during the first trimester of pregnancy, but stenosis of the main pulmonary artery or its branches has been only recently described by Rowe.'; He studied offspring of mothers who had contracted rubella during an epidemic in New Zealand and found a high incidence of varying degrees of pulmonary artery stenoses. In 11 cases of stenoses of the pulmonary artery, only three had an associated patent ductus arteriosus. His report confirmed the previous implication of maternal rubella as a cause of pulmonary stenoses."1 A history of maternal rubella has occasionally been noted in other series of patients with stenoses of the pulmonary arteries.l2--) The purpose of this report is to present findings in nine patients with pulmonary artery stenoses associated with patent ductus arteriosus. In seven, a definite history of maternal rubella during the first trimester was