Premature Newborns with Patent Ductus Arteriosus

Abstract

Patent Ductus Arteriosus (PDA) is a condition in which ductus arteriosus, which provides a connection between the main pulmonary artery and aorta descendes in fetal life, does not close in the expected period after birth. Ductus arteriosus is expected to close in the first 72 hours after birth in term infants. While functional closure occurs in the first 72 hours of life in the majority of term infants, it has been observed that the ductus that remains open in prematures causes a number of morbidities. In the early neonatal period, hemodynamic instability, heart failure, dyspnea, and/or respiratory distress requiring mechanical ventilati­on are the most common clinical signs. In preterm infants, patent ductus arteriosus was found associated with chronic lung disease, retinopathy of prematurity (ROP), increased mortality, bronchopulmonary dysplasia (BPD) due to prolonged ventilation, intraventricular bleeding, necrotizing enterocolitis (NEK), and periventricular leukomalacia. PDA is easily diagnosed with clinic, radiologic and particularly echocardiographic examination results. If it is not treated, it causes to left ventricular and atrial dilatation, progressive myocardial deterioration and congestive left heart failure. Currently, it is unclear whether and when a conservative, pharmacologic, or surgical approach for PDA closure may be advantageous. In this review, approach to patent ductus arteriosus in premature cases, physiopathology, diagnosis and treatment options will be presented.