Prediction of Ductus Arteriosus Closure by Neonatal Screening Echocardiography

Abstract

Risk factors in infants with PDA included lower BBW and larger measured DA width at the third day of life. We predicted the arterial duct would close if DA width <0.25 cm, and suggested follow up earlier if >0.25 cm on the third day of life.

Prevalence of congenital heart disease assessed by echocardiography in 2067 consecutive newborns

“…In addition, Jan et al. (26) documented that the incidence of PDA in full‐term infants is 9.1 per 1000 at 1 months of age based on a study of 1230 infants that underwent echocardiographic screening. This incidence was rather close to the rate observed in our study.…”

Patent ductus arteriosus ligation in neonates: preoperative predictors of poor postoperative outcomes

“…Ductal diameter has also been studied, although conflicting reports exist on criteria meeting hemodynamic significance. For instance, Brooks et al [19] defined a significant PDA if the duct diameter was more than 1.5 mm, whereas Jan et al [27] reported that lower birth body weight and duct diameter more than 2.5 mm on echocardiograms performed on the third day of life predicted less chance of spontaneous closure. Thus far, most studies have focused on using echocardiographic findings to predict spontaneous closure of a PDA to guide treatment options.…”

Patent ductus arteriosus evaluation by serial echocardiography in preterm infants

“…There may be a delay in the evolution of clinical signs and symptoms of PDA despite the presence of a significant ductus, potentially resulting in increased neonatal morbidity and mortality. Echocardiography is reasonably predictive of spontaneous ductal closure and useful in monitoring medical treatment (8). Several studies have shown an excellent correlation between echocardiography findings of neonatologists and cardiologists for structural heart abnormalities (9–11).…”

“…PDA was diagnosed on average on day 3 by serial echocardiography compared to day 4 (p < 0.05) by clinical signs alone (Pre-Serial Echo). The time to first course of medical treatment was also earlier in the Serial Echo group on day 3 [3][4] (median [range]) versus day 6 [4][5][6][7][8][9] in the Pre-Serial Echo group (p < 0.0001). Seven (28%) of the Pre-Serial Echo group and four (20%) of Serial Echo group required a second course of ibuprofen.…”

“…The time to second course of treatment was also reduced in the Serial Echo group at 8.5 days [7. [3][4][5][6][7][8][9], compared with the control group at 12 days [9-13] (p = 0.019) ( Table 1). Statistically, there was no difference between the groups in number requiring surgical ligation or time to ligation.…”