Persistent ductus arteriosus (PDA)

Persistent ductus arteriosus, PDA, or simply "ductus", means that the ductus or hole between the pulmonary artery and the aorta in the feotus has not closed properly.

 It mainly affects premature babies and can lead to a "reverse shunt", that is, blood that has already passed through the lungs is pumped back into the pulmonary circulation. This, in turn, can cause the blood to build up in the lungs and fluid accumulates. On an X-ray, the lungs appear white, as with pulmonary oedema. Ductus is diagnosed upon detection of a typical heart murmur, which can be heard with a stethoscope. It can also be diagnosed through ultrasound, as it is visible, and by measuring the size of the ductus and estimating the blood flow.

The symptoms of a significant ductus are fluctuating oxygenation, an increasing demand for oxygen and breathing problems secondary to fluid in the lungs.

The treatment is symptomatic with respiratory support, oxygen, CPAP or a ventilator, and diuretics if needed. There is also a targeted treatment that can help to close the ductus. Then the baby will be given ibuprofen (a common pain killer) for 3 days to treat PDA. Ibuprofen can be given either intravenously or via a feeding tube. In rare cases, the ductus may need surgical intervention to close it. It is always better to wait, if possible. The vast majority of ductus arteriosi spontaneously close when the baby approaches full term, i.e. when the baby should have been born.

Text: Kajsa Bohlin Blennow