Patent ductus arteriosus (PDA) is a heart condition affecting babies (mostly, those born prematurely). PDA causes problems with blood flow between the heart and lungs. During PDA, the aorta (the artery that carries oxygen-rich blood to the body) and the pulmonary artery (the artery that carries oxygen-poor blood to the lungs) stay connected after birth. If PDA does not resolve on its own, your healthcare provider will need to restore your baby’s normal circulation with medication, catheterization, and surgery.

What does the ductus arteriosus do?

As a fetus, there is very little blood flow to your baby’s lungs as most of the blood bypasses the baby’s lungs. This blood vessel usually closes during the baby’s first few days of life when the blood flows to the baby’s lungs.

What happens in babies with patent ductus arteriosus?

When the ductus arteriosus doesn’t close, the opening allows extra blood from the aorta to enter the baby’s lung arteries. Depending on the size of this blood vessel, your baby’s heart and lungs may have to work harder to pump blood.

What causes patent ductus arteriosus?

It’s not yet obvious what causes PDA. However, studies show PDA is more common in premature infants (About 65% of infants born before the 28th week of pregnancy). PDA is more common in girlsthan boys. Sometimes PDA occurs with other heart defects. The risk of congenital heart defects like PDA may also increase due to:

• Certain genetic conditions

• Family history of congenital heart conditions

• Fetal distress in the womb

• Infections in the mother or fetus during pregnancy, such as rubella

• Other pregnancy-related risk factors, such as smoking or taking certain medications

What are patent ductus arteriosus symptoms?

Based on the type of patent ductus arteriosus, PDA symptoms vary. Large PDAs may cause:

• Rapid breathing

• Shortness of breath (dyspnea)

• Sweating during feedings

• Fatigue or tiredness

• Feeding and eating problems

• Poor weight gain or growth

• Fast pulse or heart rate

What tests do doctors use to diagnose patent ductus arteriosus?

If PDA is suspected, you may be referred to a specialist or a pediatric cardiologist. The pediatric cardiologist may order certain tests, including:

• Chest X-ray

• Echocardiogram (heart ultrasound)

• Electrocardiogram (EKG)

How is PDA treated?

Your baby’s age, size, and health will be considered when determining a treatment plan. They may recommend regular checkups and tests to see if the PDA is closing on its own. Occasionally, treatment may not be necessary.

Healthcare providers may need to treat PDA with surgical procedures, including:

• Cardiac catheterization: During cardiac catheterization, experts insert a thin, flexible tube (catheter) into the groin and thread it up through a blood vessel to the heart. They insert a plug or coil into the heart through the catheter to close the PDA and stop patent ductus arteriosus blood flow. Providers typically don’t perform cardiac catheterization on premature babies, though older babies and children can have this procedure.

• Patent ductus arteriosus surgery: Surgeons make an incision in the side of the chest. They close the PDA with stitches (sutures) or a metal clip.

Patent ductus arteriosus and pregnancy

Most women who have a small patent ductus arteriosus can tolerate pregnancy without problems. But if you have a large defect or complications (heart failure, arrhythmias, or pulmonary hypertension) you may have a high risk of complications during pregnancy. If you have Eisenmenger syndrome, pregnancy should be avoided as it can be life-threatening.

If you have a heart defect, repaired or not, you should discuss it with your doctor before planning a family. Also, some heart medications can cause serious problems for a developing baby, and it might be necessary to stop or adjust the medications before you become pregnant.

Patent ductus arteriosus prevention

There's no sure way to prevent having a baby with a patent ductus arteriosus. But you should do anything possible to have a healthy pregnancy. Some of the basics include:

• Seek early prenatal care, even before you're pregnant: Quitting smoking, reducing stress, and stopping birth control — are all things to talk to your doctor about before you get pregnant. Also, discuss the medications you're taking.

• Eat a healthy diet: Include a vitamin supplement that contains folic acid.

• Exercise regularly: Work with your doctor to develop an exercise plan that's right for you.

• Avoid risks: These include harmful substances such as alcohol, cigarettes, and illegal drugs. Also, avoid hot tubs and saunas.

• Avoid infections: Update your vaccinations before becoming pregnant. Certain types of infections can be harmful to a developing baby.

• Keep diabetes under control: If you have diabetes, work with your doctor to manage the condition before and during pregnancy.

Conclusion

In conclusion, Patent Ductus Arteriosus (PDA) is a congenital heart defect that leaves an opening between two major blood vessels from the heart. This condition occurs when the ductus arteriosus, a blood vessel that allows blood to bypass the lungs in a fetus, fails to close after birth. If the opening is small, it may not cause any symptoms. However, a large PDA can lead to rapid heartbeat, breathlessness, poor feeding, slow growth, and low weight. Over time, it can cause high pressure in the blood vessels in the lungs, potentially leading to heart failure and other complications. Treatment options range from monitoring to medication and surgical procedures, depending on the size of the PDA and the severity of the symptoms. Despite the potential complications, with early diagnosis and appropriate treatment, most children with PDA can lead healthy lives.