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PATENT DUCTUS ARTERIOUSUS
(PDA)
CONTENT
What is the PDA
What causes the PDA
What are the symptoms
How is it diagnosed
How is it treated
WHAT IS THE PDA
1. In the womb the Ductus Arteriosus (duck-tuss are-tear-E-oh-sus) is part of the
normal circulation (blood flow) for the fetus. It allows blood to by-pass (flow away)
from the lungs. This flow is called fetal circulation and is very important for the
fetus’ well being.
2. During pregnancy the baby’s blood gets its oxygen from its mother.
3. The fetal lungs are not used for breathing and it’s not necessary for the blood to go
to the lungs. This is completely normal for the fetus.
4. At birth the lungs inflate and the baby’s oxygen comes from its own lungs.
5. The ductus arteriosus is no longer needed and closes to allow blood to flow to the
lungs.
6. If the ductus arteriosus does not close after birth we call it the Patent (pay-tent)
Ductus Arteriosus (PDA).
7. The PDA is a temporary connection between the vessel (pulmonary artery) that leads
to the lungs and the vessel that leads to the baby’s body (aorta).
8. It is common for the PDA to remain open in the premature baby.
Aorta
The PDA
Pulmonary
Artery
PDA 1
WHAT CAUSES THE PDA
1. The PDA is more likely to stay open or re-open in babies born early.
2. Other conditions that may cause a baby to have a PDA are:
a. Respiratory Distress Syndrome (RDS)
b. A severe or prolonged decrease in the baby’s oxygen saturation level
c. If the baby’s system has too much fluid or the kidneys are not working well.
3. Sometimes the PDA stays open for no obvious (clear) reason.
WHAT ARE THE SYPMTOMS
The baby may or may not have any of the following symptoms:
1. Fast heart rate (tachycardia/tack-a-car-dee-a.)
2. Fast breathing rate (tachypnea/ta-kip-knee-a.)
3. A heart murmur may or may not be heard. A murmur is an extra sound made by the
blood flowing through a narrow opening.
4. Active precordium. You may see or feel the baby’s heart beating in his chest.
5. Changes in oxygen needs or amount of respiratory support.
HOW IS THE PDA DIAGNOSED
1. The period of time that it takes the PDA to close varies. Some babies will adjust to
the PDA without problems; other babies may have problems.
2. If the doctor notices any of the symptoms listed above and thinks the baby has a
PDA, he/she may order an echocardiogram (echo-car-dee-oh-gram.)
3. An echocardiogram is a painless ultrasound of the heart. It uses high frequency
sound waves to measure blood flow and is done at your baby’s bedside.
4. The doctor may ask a pediatric cardiologist to check your baby. A pediatric
cardiologist is a specialist who is trained to diagnose and treat heart problems in
infants and children.
HOW IS IT TREATED
1. Sometimes, a baby with a small PDA that is not causing any problems may just be
watched over time (see the doctor more often).
2. The treatment will depend upon how large the PDA is and how severe your baby’s
symptoms are. Some of the first things we may do are:
a. Limit the fluid the baby gets.
b. Diuretics may be given. These are medications that make the baby wet his/her
diapers more and help him/her get rid of extra fluid. It also reduces the work
of the heart and lungs.
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c. Give extra oxygen and/or respiratory support.
d. Blood transfusion may be given if the baby’s hematocrit (he-mat-toe-crit) is low.
A hematocrit is the number of red blood cells the baby has. This would improve
the baby’s ability to carry oxygen through its body.
e. Give Indocin—a medication that helps close the PDA.
f. We may repeat the echocardiogram to see if the medicine is making the PDA
close.
g. Order a sedative—a medication that helps your baby to rest. Oxygen levels are
easier to keep at an optimum level when the baby is relaxed.
3. If the medicine doesn’t close the PDA or if the baby can’t take the medicine, surgery
may be the treatment.
a. If surgery is necessary, a surgeon makes a small incision in the baby’s chest and
“ties off” the PDA
b. The surgeon does not have to open the heart to correct this blood flow
c. If there is no other defect, this restores the blood flow to normal
d. We will talk with you about this before we do the surgery. (see PDA Surgery for
additional information.)
4. If the PDA does not close on its own, there is a way to close it without surgery using
a catheter when the baby is older.
Reviewed/Revised: 09/98…..09/11
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