Patent ductus arteriosus medical therapy in preterm infants
Patent Ductus Arteriosus Microchapters |
Differentiating Patent Ductus Arteriosus from other Diseases |
---|
Diagnosis |
Treatment |
Medical Therapy |
Case Studies |
Patent ductus arteriosus medical therapy in preterm infants On the Web |
American Roentgen Ray Society Images of Patent ductus arteriosus medical therapy in preterm infants |
FDA on Patent ductus arteriosus medical therapy in preterm infants |
CDC on Patent ductus arteriosus medical therapy in preterm infants |
Patent ductus arteriosus medical therapy in preterm infants in the news |
Blogs on Patent ductus arteriosus medical therapy in preterm infants |
Risk calculators and risk factors for Patent ductus arteriosus medical therapy in preterm infants |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief:Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3] Priyamvada Singh, MBBS [[4]]
Assistant Editor-In-Chief: Kristin Feeney, B.S. [[5]]
In term infants the ductus closure occur in 50% of babies by 24 hours of bith, 90% of babies by 48 hour and by 72 hours in most of the patients.The ductal closure is delayed in preterm infants.
Ductal constriction occurs after birth due to following reasons-
- The increased oxygen tension after birth with onset of breathing
- Decreased prostaglandin E2 due to removal of placenta
- Increased removal of prostaglandin from lungGestational age has a major impact upon the rate of ductal closure.
Medical therapy
- Circulating prostaglandin E2 has been found to play a key role in maintaining the patency of ductus arterisus(DA)in the fetal life. Thus, use of inhibitors of prostaglandin synthesis (eg, indomethacin and ibuprofen) have been found to be effective in the treatment of PDA. These drugs were also found to be useful in ductus closure if given antenatally.
- Steroids like hydrocortisone have been found to decrease the sensitivity of ductus to PGE2.Thus, facilitating ductal constriction.
- Nitic oxide synthesized from endothelial cells have been shown to cause ductus constriction in animal studies.