Patent Ductus Arteriosus

Persistent PDA is diagnosed when the Ductus Arteriosus does not close after 72 hours

Ductus arteriosus- Is important for foetal circulation and it allows communication between pulmonary artery and the aortic arch distal to the left subclavian artery. This shunt allows oxygenated blood from the placenta to bypass the uninflated fetal lungs and enter the systemic circulation.

DA closes soon after birth normally within 48 hours- Closure happens due to factors as increasing arterial PaO2 decreasing prostaglandin levels and bradykinin the vessel wall dies and changes to ligamentum arteriosus.

Who is at risk - PDA can be seen in patients of all ages Premature infants are at risk of PDA - inversely associated with degree of prematurityparticularly high incidence if GA < 29 weeks PDA correlates inversely with birth weight and gestational age- seen in about 30 % of infants with birth weigh < 1500 gms- 40 % of infants with birth weight 751-1000 gms &- 50 % of those weighing 501-750 gms Other risk factors in premature infants include- maternal rubella- respiratory distress syndrome- high volume of IV fluids in the 1st week- sepsis- prolonged rupture of membranes- furosemide- male sex ( BMJ Best practice mentions female sex )-...