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Successful Closure of Patent Ductus Arteriosus by Late Pharmacologic Treatment in a Small Preterm Infant

Received: 4 November 2019     Accepted: 28 November 2019     Published: 10 December 2019
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Abstract

The ductus arteriosus (DA) is a temporary communicative pathway that connects the pulmonary artery to the aorta during fœtal life. Although usually closing on its own in the initial days of postnatal life, the persistent patency of the DA is common in preterm or low birth weight babies, and can lead to life-threatening complications. Early diagnosis and pharmacologic management of patent ductus arteriosus (PDA) could prevent further need for invasive surgery or transcatheter intervention. Pharmacologic treatment for PDA closure in preterm infants is achieved by cyclooxygenase inhibitors (COXi) and paracetamol. However, their effectiveness is fully demonstrated when they are used early within the first week of postnatal life. We report here the case of a severe preterm infant of 27 weeks gestation age with extremely low birth weight (995g), who had a PDA with moderate to severe shunting closed after late administration of intravenous ibuprofen. Ibuprofen was started on postnatal day 40, and the PDA got closed after a three-day course of treatment. No complication related to the treatment was reported. The DA remained closed when the infant was seen on review for echocardiography at the age of six months. Wherever cardiac surgery and transcatheter intervention are not available nor affordable, possible effectiveness of COXi even in case of late diagnosis of PDA, offers an unexpected opportunity to cure at a very cheaper cost, one of the commonest congenital heart disease.

Published in American Journal of Pediatrics (Volume 5, Issue 4)
DOI 10.11648/j.ajp.20190504.29
Page(s) 276-280
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Patent Ductus Arteriosus, Preterm Infant, Ibuprofen

References
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Cite This Article
  • APA Style

    Boro Theodore, Ouedraogo Paul, Bama Aime, Seghda Arthur, Zagre Nicaise, et al. (2019). Successful Closure of Patent Ductus Arteriosus by Late Pharmacologic Treatment in a Small Preterm Infant. American Journal of Pediatrics, 5(4), 276-280. https://doi.org/10.11648/j.ajp.20190504.29

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    ACS Style

    Boro Theodore; Ouedraogo Paul; Bama Aime; Seghda Arthur; Zagre Nicaise, et al. Successful Closure of Patent Ductus Arteriosus by Late Pharmacologic Treatment in a Small Preterm Infant. Am. J. Pediatr. 2019, 5(4), 276-280. doi: 10.11648/j.ajp.20190504.29

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    AMA Style

    Boro Theodore, Ouedraogo Paul, Bama Aime, Seghda Arthur, Zagre Nicaise, et al. Successful Closure of Patent Ductus Arteriosus by Late Pharmacologic Treatment in a Small Preterm Infant. Am J Pediatr. 2019;5(4):276-280. doi: 10.11648/j.ajp.20190504.29

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  • @article{10.11648/j.ajp.20190504.29,
      author = {Boro Theodore and Ouedraogo Paul and Bama Aime and Seghda Arthur and Zagre Nicaise and Zabsonre Patrice and Simpore Jacques},
      title = {Successful Closure of Patent Ductus Arteriosus by Late Pharmacologic Treatment in a Small Preterm Infant},
      journal = {American Journal of Pediatrics},
      volume = {5},
      number = {4},
      pages = {276-280},
      doi = {10.11648/j.ajp.20190504.29},
      url = {https://doi.org/10.11648/j.ajp.20190504.29},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.29},
      abstract = {The ductus arteriosus (DA) is a temporary communicative pathway that connects the pulmonary artery to the aorta during fœtal life. Although usually closing on its own in the initial days of postnatal life, the persistent patency of the DA is common in preterm or low birth weight babies, and can lead to life-threatening complications. Early diagnosis and pharmacologic management of patent ductus arteriosus (PDA) could prevent further need for invasive surgery or transcatheter intervention. Pharmacologic treatment for PDA closure in preterm infants is achieved by cyclooxygenase inhibitors (COXi) and paracetamol. However, their effectiveness is fully demonstrated when they are used early within the first week of postnatal life. We report here the case of a severe preterm infant of 27 weeks gestation age with extremely low birth weight (995g), who had a PDA with moderate to severe shunting closed after late administration of intravenous ibuprofen. Ibuprofen was started on postnatal day 40, and the PDA got closed after a three-day course of treatment. No complication related to the treatment was reported. The DA remained closed when the infant was seen on review for echocardiography at the age of six months. Wherever cardiac surgery and transcatheter intervention are not available nor affordable, possible effectiveness of COXi even in case of late diagnosis of PDA, offers an unexpected opportunity to cure at a very cheaper cost, one of the commonest congenital heart disease.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Successful Closure of Patent Ductus Arteriosus by Late Pharmacologic Treatment in a Small Preterm Infant
    AU  - Boro Theodore
    AU  - Ouedraogo Paul
    AU  - Bama Aime
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    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20190504.29
    AB  - The ductus arteriosus (DA) is a temporary communicative pathway that connects the pulmonary artery to the aorta during fœtal life. Although usually closing on its own in the initial days of postnatal life, the persistent patency of the DA is common in preterm or low birth weight babies, and can lead to life-threatening complications. Early diagnosis and pharmacologic management of patent ductus arteriosus (PDA) could prevent further need for invasive surgery or transcatheter intervention. Pharmacologic treatment for PDA closure in preterm infants is achieved by cyclooxygenase inhibitors (COXi) and paracetamol. However, their effectiveness is fully demonstrated when they are used early within the first week of postnatal life. We report here the case of a severe preterm infant of 27 weeks gestation age with extremely low birth weight (995g), who had a PDA with moderate to severe shunting closed after late administration of intravenous ibuprofen. Ibuprofen was started on postnatal day 40, and the PDA got closed after a three-day course of treatment. No complication related to the treatment was reported. The DA remained closed when the infant was seen on review for echocardiography at the age of six months. Wherever cardiac surgery and transcatheter intervention are not available nor affordable, possible effectiveness of COXi even in case of late diagnosis of PDA, offers an unexpected opportunity to cure at a very cheaper cost, one of the commonest congenital heart disease.
    VL  - 5
    IS  - 4
    ER  - 

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Author Information
  • Cardiology Unit, Saint Camille Hospital, Ouagadougou, Burkina Faso

  • Department of Neonatology, Saint Camille Hospital, Saint Thomas d’Aquin University, Ouagadougou, Burkina Faso

  • Cardiology Unit, Charles De Gaulle Paediatric University Hospital, Ouagadougou, Burkina Faso

  • Department of Cardiology, Bogodogo University Hospital, Ouagadougou, Burkina Faso

  • Department of Neonatology, Saint Camille Hospital, Saint Thomas d’Aquin University, Ouagadougou, Burkina Faso

  • Department of Cardiology, Yalgado Ouedraogo University Hospital, University Ouaga I Prof. Joseph Ki-Zerbo, Ouagadougou, Burkina Faso

  • Department of Microbiology and Biochemistry, Laboratory of Molecular Biology and Genetics (LABIOGENE), University Ouaga I Prof. Joseph Ki-Zerbo, Saint Thomas d’Aquin University, Ouagadougou, Burkina Faso

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