Prevalence of patent ductus arteriosus in premature infants at the Neonatal Ward, Cipto Mangunkusumo Hospital, Jakarta

  • Benita Deselina
  • Sukman Tulus Putra
  • Rulina Suradi
Keywords: preterm infant, patent ductus arteriosus, incidence, echocardiography

Abstract

Background Patent ductus arterious (PDA) is one of the most
common congenital heart diseases encountered in preterm infants.
The lower the birth weight and gestational age are, the higher the
incidence of PDA is.
Objectives To investigate the incidence of PDA in premature infants
hospitalized in the neonatal wards of Cipto Mangunkusumo Hospital
using echocardiography.
Methods Preterm infants born between August and October 2003
were included in this study. Clinical features were retrieved from medical
charts. The first echocardiography was conducted on all of the preterm
infants at the chronological age of 3 days. If PDA was detected,
echocardiography was repeated at the chronological age of 6 days.
Results During the 3-month period, sixty-five preterm infants
participated in this study and underwent echocardiography. In the
first echocardiogram, the incidence rate of PDA was 32%. At
gestational age of less than 28 weeks, 1 of 2 infants had PDA. Of 3
infants with birth weight of more than 1000 grams, 2 had PDA. On
the second echocardiography, the incidence rate of PDA was 14%
and mostly found in infants at gestational age of less than 28 weeks
(8/9) and in those with birth weight of less than 1000 grams (7/9).
All infants with RDS whose PDA was identified in the first
echocardiography proved to maintain their PDA in the second
echocardiography.
Conclusion The incidence rate of PDA in preterm infants was
14%. The lower the birth weight, the higher the incidence rate of
PDA. The presence of RDS is related to the delay in the closing of
the arterial duct

Author Biographies

Benita Deselina
Department of Child Health, Medical School, Universiy of
Indonesia, Jakarta, Indonesia.
Sukman Tulus Putra
Department of Child Health, Medical School, Universiy of
Indonesia, Jakarta, Indonesia.
Rulina Suradi
Department of Child Health, Medical School, Universiy of
Indonesia, Jakarta, Indonesia.

References

1. Clyman RI. Ibuprofen and patent ductus arteriosus. N
Eng J Med 2000;343:728-9.
2. Archer N. Patent ductus arteriosus in the newborn. Arch
Dis Child 1993;69:529-32.
3. Skinner J. Diagnosis of patient ductus arteriosus. Semin
Neonatal 2001;6:49-61.
4. Lim MK. Hanretty K. Houston AB, Lilley S. Intermit-
tent ductal patency in healthy newborn infants: demon-
stration by colour-Doppler flow mapping. Arch Dis Child
1992;67:1217-8.
5. Evans NJ, Arcer NJ. Postnatal circulatory adaptation
in healthy term and preterm neonates. Arc Dis Child
1990;65:24-6.
6. Mullins CE. Patent ductus arteriosus. In: Garson A,
Bricker JT, McNamar DG, editors. The science and prac-
tice of pediatric cardiology. 2nd ed. Philadelphia: Lea
and Febiger; 1990. p.1055-72
7. Reller MD, Colasurdo Ma, Rice MJ. The timing of
spontaneous closure of the ductus arteriosus in in-
fants with respiratory distress syndrome. Am J Cardiol
1990;25:75-66.
8. Reller MD, Rice GM. Mc.Donald RW. Review of
studies evaluating ductal patency in premature infant.
J Pediatr 1993;22(Suppl):59-62.
9. Jones RW, Pickering D. Persistent ductus arteriosus
complicating the respiratory distress syndrome. Arch
Dis Child 1977;52:274-81.
10. Knight DB. The treatment of patent ductus arteriosus
in preterm infants. A review and overview of
randomized trials. Semin neonatal 2001;6:63-73.
11. Ellison RC, Peckham GJ, Lang P. Evaluation of the
preterm infant of patent ductus arteriosus. Pediatrics
1983;71:364-72.
12. Eronem M. The effect of antenatal dexamethasone
administration of the fetal and neonatal ductus
arteriosus. A randomized double blind study. Am J Dis
Child 1993;147;187-92.
13. Kluckow M, Evans N. Early echocardiographic predic-
tion of symtomatic patent ductus arteriosus in preterm
infants undergoing mechanical ventilation. J Pediatr
1995;127:774-9.
14. Roberson DA, Silverman NH. Color Doppler flow map-
ping of the patent ductus arteriosus in very low birth
weight neonatus: echocardiographic and clinical find-
ings. Pediatr cardiol 1994;15: 219-24.
15. Evans N. Diagnosis of patent ductus arteriosus in the
preterm newborn. Arch dis Child 1993;68: 58-61.
16. Ballard JL, Khoury JC, Wedig K, Wang L. New Ballard
Score, expanded to include extremely premature
infants. J Pediatr 1991;119:417-23
17. Sastroasmoro S. Dasar diagnosis dan tatalaksana
penyakit jantung bawaan. Jakarta: Perhimpunan
Kardiologi Anak Indonesia; 1998. p. 3-40.
18. Brook MM, Heymann MA. Patent ductus arteriosus.In:
Pine JW, Moss and Adams M,editors. Heart disease in
infants, children and adolescent. Baltimore: Williams and
Wilkins; 1995. p. 746-64.
19. Musewe NN, Olley PM. Patent ductus arteriosus. In:
Freedom RM, Benson LN, Smallhom JF, editors. Neo-
natal Heart Diseases. London: Springer-verlag; 1992. p.
593-607.
20. Reller MD, Ziegler ML, Rice MJ. Duration of ductal
shunting in healty preterm infants: an
echocardiographic color flow Doppler study. J Pediatr
1988;112:441-6.
21. Siassy B, Blanco C, Coran AG. Incidence and clinical
features of PDA in low birth weight infants: a
prospective analysis of 150 consecutively born infants.
Pediatrics 1976;57:347-51.
22. Reller MD, Laird MR, Rice MJ. Timing of ductal closure
in very low birth weight premature infants without
respiratory distress. J Pediatr 1991;119:976-7.
23. Hammerman C. Patent ductus arteriosus: clinical preva-
lence of prostaglandin inhibitor in PDA pathophysiology
and treatment. In: Caplan MS. Hageman JR, editors.
Clinics in perinatalogy. Philadelphia: WB Saunders; 1995.
p. 457-79.
24. Waffarn F, Siassi B, Cobal LA. Effect of antenatal
glucocorticoids of clinical closure of the ductus
arteriosus. Am J Dis Child 1983;37:336-8.
Published
2016-10-10
How to Cite
1.
Deselina B, Putra S, Suradi R. Prevalence of patent ductus arteriosus in premature infants at the Neonatal Ward, Cipto Mangunkusumo Hospital, Jakarta. PI [Internet]. 10Oct.2016 [cited 22Nov.2024];44(6):223-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/782
Received 2016-10-03
Accepted 2016-10-03
Published 2016-10-10