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Patent Ductus Arteriosus in the Preterm Infant (PDA)

Persistence of the ductus arteriosus in preterm infants leads to pulmonary overload and respiratory compromise.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Patent Ductus Arteriosus in the Preterm Infant (PDA)?

The ductus arteriosus is the vessel between the pulmonary artery and aorta that bypasses the lungs in fetal circulation. In a normal term infant it closes functionally within 24-72 hours and anatomically within 2-3 weeks. In preterm infants this process can be delayed and a hemodynamically significant PDA may develop.

In hemodynamically significant PDA the left-to-right shunt causes pulmonary overcirculation, pulmonary edema and impaired oxygenation, while systemic perfusion decreases (diastolic steal). Prolonged ventilator support, BPD, NEC, IVH and retinopathy risks increase.

Treatment is individualized. Conservative approach with fluid restriction and optimization of respiratory support is the first step. Pharmacologic closure may be attempted with indomethacin, ibuprofen or paracetamol. Surgical ligation or transcatheter closure is considered when these fail.

Symptoms

Active precordium
Continuous or systolic murmur
Wide pulse pressure
Tachypnea and tachycardia
Need for increased ventilator settings
Failure to thrive
Pulmonary vascular markings on chest X-ray

Risk Factors

Low gestational age
Low birth weight
Respiratory distress syndrome
Sepsis
Excessive fluid loading
Lack of antenatal corticosteroids

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When a continuous murmur is detected in a preterm infant
  • If ventilator settings continue to be increased
  • When echocardiography shows a significant PDA
  • When feeding intolerance or NEC risk increases
  • When findings of pulmonary edema are detected

Treatment Methods

01
Conservative: fluid restriction, optimal ventilation
02
IV/oral ibuprofen or indomethacin
03
IV/oral paracetamol
04
Surgical ligation (failed cases)
05
Transcatheter PDA closure
06
Serial echocardiographic monitoring

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.