Patent ductus arteriosus (PDA) is a persistent opening between the two major blood vessels leading from the heart. The opening is called Ductus Arteriosus, is a normal part of a baby's circulatory system before birth that usually closes shortly after birth. when the baby is still in the mother’s womb, they didn’t require lungs to supply oxygen because they receive oxygen from their mother. Hence there is no need for the heart to pump blood to the lungs. The Ductus Arteriosus is present in all babies while still in the womb, and it allows blood to bypass the lungs.
In most babies who have normal heart, PDA will shrink and close by its own. the ductus arteriosus usually closes within the first hours of life. sometimes, the Ductus Arteriosus does not close on its own. This is known as a Patent Ductus Arteriosus. Mostly this condition is seen in premature babies, sometimes it has also appeared in full-term babies. Small PDA that doesn't close early will seal up on their own by the time the child is a year old. If PDA stays open for longer, then the extra blood will flow to the lungs.
Signs & Symptoms of Patent Ductus Arteriosus
the PDA symptoms vary with the size of the defect and whether the baby is full term or premature. A small PDA might cause no signs or symptoms and left undetected for some time. A large PDA shows signs of heart failure as soon after birth.
Dr. Suresh Rao from Kokilaben Dhirubhai Ambani Hospital says” the basic symptoms of heart problems are: a child may require ventilation, a child may not gain weight, they get record Respiratory infection”.
A large PDA found during childhood might cause:
- Poor eating
- Sweating with crying or eating
- Persistent fast breathing or breathlessness
- Easy tiring
- Rapid heart rate
- Abounding (strong and forceful) pulse
- Fast breathing
- Not feeding well
- Shortness of breath
- Sweating while feeding
- Tiring very easily
- Poor growth
- Childs age, overall health
- Childs medical history
- The extent of the disease
- the child's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
Symptoms of PDA
Causes of Patent Ductus Arteriosus
It is a congenital heart defect, means the problem early in the heart's development. The cause of PDA is unknown, but genetics might play a role. PDA is common among premature babies. the connection often takes longer to close. If the connection remains open, it's referred to as a patent ductus arteriosus.
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Risk Factor of Patent Ductus Arteriosus
Family history and other genetic conditions:
If you have a family history of heart defect or another genetic condition such as Down syndrome, it increases the risk of having PDA.
1. Premature birth: PDA occurs in premature babies who are born too early than in babies who are born full term
2. Rubella infection during pregnancy: If the mother gets contract Rubella virus during pregnancy. your baby's risk of heart defects increases.
3. Being born at a high altitude: Babies born above 10,000 feet have a greater risk of a PDA than babies born at lower altitudes.
4. Being female: PDA is twice common in girls.
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Small PDA might not cause complications. Larger, untreated defects could cause serious problems:
1. High blood pressure in the lungs: Too much blood circulating through the heart's main arteries through a PDA can lead to pulmonary hypertension.
2. Heart Failure: PDA eventually cause the heart to enlarge and weaken, leading to heart failure
3. Heart infection: People who have PDA are at a higher risk of an inflammation of the heart's inner lining than are people who have healthy hearts.
Treatment for Patent Ductus Arteriosus
The treatment for PDA will be determined by your child's doctor based on:
small Patent Ductus Arteriosus can close by its own as a child grows. A child showing symptoms will require a medical attendance and possible even a surgical repair. A cardiologist will monitor closely to see whether the PDA is closing on its own. If a PDA does not close on its own, it should be repaired to prevent lung problems. A closure of defect is usually recommended as a high risk of cardiac complications and early death related to PDA.
1. Wait and Watch:
Many times, in a premature baby, PDA close on its own. Your cardiologist will monitor a baby's heart closely to make sure the open blood vessel is closing properly. For children who have small PDA that aren't causing other health problems, only monitoring might be needed.
2. Medications:
In premature infant anti inflammations drugs such as indomethacin or ibuprofen (Advil, Infant's Motrin) might be used to close the PDA. Indomethacin is related to aspirin and ibuprofen and works by stimulating the muscles inside the PDA to constrict, thereby closing the connection.
3. Surgical closure:
If the medication is not effective and a child's condition is causing complications, surgery might be recommended. Open heart surgery is a standard surgical procedure. In this procedure, the surgeon opens the child's ribs to reach its heart and repair the open duct using stitches or clips. After a surgery child remains in the hospital for several days. It will take a few weeks to a child to fully recover from the surgery.
4. Catheter Procedures:
Nowadays, more than 95 percent of PDAs can now be closed by catheter-based techniques. Premature babies are too small for Catheter procedure. However, if a baby doesn't have PDA related health issues then a doctor may recommend waiting until the baby is older to repair catheter procedure to correct the PDA.
In this procedure, a catheter is inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug is inserted to close the ductus arteriosus.
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Prevention:
There is no sure way to prevent having a baby with a patent ductus arteriosus (PDA), however, it is important to do everything possible to have a healthy pregnancy.
1. Seek early prenatal care: Reduce stress, quit smoking, stop taking birth control pills.
2. Eat healthy Diet: Eat a proper diet, as recommend by your physician, include a vitamin supplement that contains folic acid.
3. Exercise regularly: Consult your doctor and work on your work out plan that’s right for you.
4. Avoid risk: These include harmful substances such as alcohol, cigarettes and illegal drugs.
5. Keep diabetes under control: work with your doctor to manage the condition before and during pregnancy.
6. Avoid infections: Update your vaccinations before becoming pregnant. certain infections can be harmful to a developing baby.
