Patent ductus arteriosus (PDA) is a condition in which the blood vessels connecting the aorta and pulmonary arteries remain open after the baby is born. PDA is a type of congenital heart defect that is usually experienced by premature babies.
While in the womb, the baby does not need lungs to breathe because it is already getting oxygen from the placenta (placenta). Therefore, most of the blood going to the lungs is diverted to the rest of the body through the ductus arteriosus.
The ductus arteriosus is a blood vessel that connects the aorta (a vessel that carries oxygen-rich blood from the heart to the rest of the body) and the pulmonary artery (a vessel that carries blood from the heart to the lungs).
This channel should close automatically within 2-3 days after birth, because the baby's lungs have started working to fill the blood with oxygen. However, in a patent ductus arteriosus , this duct remains open. As a result, blood in PDA sufferers becomes minimally oxygenated.
Patent Ductus Arteriosus Causes and Risk Factors
Until now it is not known exactly what causes PDA. However, there are a number of factors that are thought to increase the risk of a baby experiencing this condition, namely:
PDA is 2 times more common in baby girls than baby boys.
Rubella infection in pregnant women
Rubella virus in the womb can spread to the baby's respiratory system and then damage the heart and blood vessels.
Born in highlands
The risk of developing PDA is higher for babies born in areas with an altitude of more than 2500 meters above sea level.
History of disease
Babies born into families with a history of heart defects or babies who have certain genetic disorders, such as Down's syndrome , are more at risk of developing PDA.
The smaller the gestational age when the baby is born, the greater the chance of PDA. More than 50% of premature babies born at less than 26 weeks and about 15% of babies born at 30 weeks have PDA.
Patent Ductus Arteriosus
PDA symptoms depend on the size of the ductus arteriosus that opens. PDAs with small openings sometimes don't cause any symptoms, even into adulthood. However, a PDA with a wide opening can cause heart failure in the baby shortly after birth.
A number of symptoms of a wide-open PDA include:
- Easily tired
- Breastfeeding is not smooth (often stops in the middle)
- Sweating while eating or crying
- Rapid or labored breathing
- Heart beats fast
- Hard to gain weight
When to see a doctor
Check with the doctor if your child shows the above complaints. In addition, be aware of signs of shortness of breath in babies, such as:
- Rapid breath
- The area under or between the ribs seems to be pulled in when you breathe
- Nostrils that rise and fall when breathing
- Makes a whistling sound when the baby breathes
Immediately take the child to the emergency room if he shows the signs above.
Diagnosis Patent Ductus Arteriosus
Doctors can diagnose PDA by listening to a baby's heartbeat through a stethoscope. The heart of a baby with PDA generally makes a loud noise when it beats. Several further tests can also be carried out to confirm the diagnosis, such as:
This examination uses sound waves to produce a detailed picture of the heart. Through echocardiography , doctors can determine the heart's ability to pump blood and blood flow in the heart, including abnormal blood flow that occurs in PDAs.
This examination can show abnormalities in the size of the heart muscle and heart rhythm disturbances.
This examination will help the doctor see the condition of the baby's lungs and heart.
Treatment of patent ductus arteriosus
Babies with relatively small ductus arteriosus openings do not need treatment. This is because PDA openings generally close by themselves as they age. The doctor will only suggest routine checks to monitor the baby's condition.
Treatment will be advised if the ductus arteriosus opening does not close on its own or if the opening is large. Available treatment methods include:
For cases of PDA in premature babies, doctors can prescribe non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and indomethacin . These drugs can help close the opening of the ductus arteriosus . However, PDA in full-term infants, children, or adults cannot be treated with this drug.
Installation of stoppers
For babies born at full term or toddlers and adults who still have small PDA openings, the doctor will install a plug. In this procedure, the doctor will first insert a catheter ( cardiac catheterization procedure ) into the heart's blood vessels through the groin.
After that, the doctor will insert a plug through the catheter to be installed in the opening of the ductus arteriosus . Through this action, blood flow will return to normal.
For PDAs with wide openings, the doctor will suggest a surgical procedure. Generally, this procedure is performed on babies aged 6 months and over. However, surgery can also be applied to babies aged 6 months and under who experience symptoms.
Surgery is done by making an incision between the baby's ribs. After that, the doctor will close the opening using clips or stitches. In order to prevent infection after surgery, the doctor will prescribe antibiotics.
Patent ductus arteriosus complications
PDAs with wide openings and not treated immediately can trigger a number of the following complications:
PDA heart failure
can cause the heart to enlarge and weaken, so that over time it can trigger heart failure.
hypertension Pulmonary hypertension is high blood pressure in the blood vessels of the lungs which can cause permanent damage to the lungs and heart.
Heart infection (endocarditis)
People who have a PDA are more at risk of developing endocarditis or inflammation of the inner lining of the heart (endocardium).
Prevention of patent ductus arteriosus
Patent ductus arteriosus cannot always be prevented. However, there are several ways that pregnant women can do to reduce the risk of their baby getting this disease, namely:
- Eat nutrient-rich foods, including vitamin supplements that contain folic acid
- Avoid cigarettes, alcoholic beverages , and drugs
- Get vaccinated before pregnancy to prevent infection
- Keep blood sugar levels under control
- Manage stress well
- Exercise regularly