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Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases

BACKGROUND: Persistent Ductus Arteriosus (PDA) is a vascular structure that connects the pulmonary artery and the descending aorta. It plays an important role in the fetal blood flow pattern. OBJECTIVE: The aim of this paper is to present two cases from Neonatology of Cantonal hospital in Bihac, wit...

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Autores principales: Kardasevic, Mediha, Mesihovic-Dinarevic, Senka, Kecalovic, Azra Hadzic
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Medical Sciences of Bosnia and Herzegovina 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802680/
https://www.ncbi.nlm.nih.gov/pubmed/35169376
http://dx.doi.org/10.5455/medarh.2021.75.467-470
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author Kardasevic, Mediha
Mesihovic-Dinarevic, Senka
Kecalovic, Azra Hadzic
author_facet Kardasevic, Mediha
Mesihovic-Dinarevic, Senka
Kecalovic, Azra Hadzic
author_sort Kardasevic, Mediha
collection PubMed
description BACKGROUND: Persistent Ductus Arteriosus (PDA) is a vascular structure that connects the pulmonary artery and the descending aorta. It plays an important role in the fetal blood flow pattern. OBJECTIVE: The aim of this paper is to present two cases from Neonatology of Cantonal hospital in Bihac, with hemodynamically significant ductus, different “timing” of treatment and different therapeutic options. RESULTS AND DISCUSSION: The ductus closes functionally within the first 72 to 96 hours after the birth. Its anatomical closure follows in the next 14 days. If it remains open after the third month of life, it is treated as a congenital heart anomaly with a left-right shunt. Approximately 10% of all congenital heart defects are PDA with an incidence of 2-4 per 1000 live births. It has been clinically proven that PDA is present in 45% of premature babies with a birth weight of less than 1750 g and in about 80% of premature babies with a birth weight below 1200 g. As criteria for the application of drug therapy (in this case we use Paracetamol) for ductal closure, we took into account clinical parameters and echo parameters that indicated that it was a hemodynamically significant ductal shunt. Prerequisites for treatment were normal liver function confirmed by laboratory tests, normal platelet count, no intracranial hemorrhage, normal gastrointestinal function, normal coagulation parameters, normal renal function, calm parameters of inflammation. CONCLUSION: The diagnosis of PDA in the early, asymptomatic phase, in premature babies, is made by early echocardiographic examination. The decision on treatment should be based on clinical and echocardiographic criteria. Paracetamol is an alternative in the treatment of this cardiac problem of premature infants and could be more effective if used in early, presymptomatic phase.
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spelling pubmed-88026802022-02-14 Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases Kardasevic, Mediha Mesihovic-Dinarevic, Senka Kecalovic, Azra Hadzic Med Arch Case Report BACKGROUND: Persistent Ductus Arteriosus (PDA) is a vascular structure that connects the pulmonary artery and the descending aorta. It plays an important role in the fetal blood flow pattern. OBJECTIVE: The aim of this paper is to present two cases from Neonatology of Cantonal hospital in Bihac, with hemodynamically significant ductus, different “timing” of treatment and different therapeutic options. RESULTS AND DISCUSSION: The ductus closes functionally within the first 72 to 96 hours after the birth. Its anatomical closure follows in the next 14 days. If it remains open after the third month of life, it is treated as a congenital heart anomaly with a left-right shunt. Approximately 10% of all congenital heart defects are PDA with an incidence of 2-4 per 1000 live births. It has been clinically proven that PDA is present in 45% of premature babies with a birth weight of less than 1750 g and in about 80% of premature babies with a birth weight below 1200 g. As criteria for the application of drug therapy (in this case we use Paracetamol) for ductal closure, we took into account clinical parameters and echo parameters that indicated that it was a hemodynamically significant ductal shunt. Prerequisites for treatment were normal liver function confirmed by laboratory tests, normal platelet count, no intracranial hemorrhage, normal gastrointestinal function, normal coagulation parameters, normal renal function, calm parameters of inflammation. CONCLUSION: The diagnosis of PDA in the early, asymptomatic phase, in premature babies, is made by early echocardiographic examination. The decision on treatment should be based on clinical and echocardiographic criteria. Paracetamol is an alternative in the treatment of this cardiac problem of premature infants and could be more effective if used in early, presymptomatic phase. Academy of Medical Sciences of Bosnia and Herzegovina 2021-12 /pmc/articles/PMC8802680/ /pubmed/35169376 http://dx.doi.org/10.5455/medarh.2021.75.467-470 Text en © 2021 Mediha Kardasevic, Senka Mesihovic-Dinarevic, Azra Hadzic Kecalovic https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kardasevic, Mediha
Mesihovic-Dinarevic, Senka
Kecalovic, Azra Hadzic
Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases
title Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases
title_full Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases
title_fullStr Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases
title_full_unstemmed Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases
title_short Therapeutic Modalities in the Treatment of Persistent Ductus Arteriosus in Premature Babies: Report of Two Cases
title_sort therapeutic modalities in the treatment of persistent ductus arteriosus in premature babies: report of two cases
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802680/
https://www.ncbi.nlm.nih.gov/pubmed/35169376
http://dx.doi.org/10.5455/medarh.2021.75.467-470
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