Wednesday, November 13, 2013

PAM FOD #11 - Preemie complications: PDA

Prematurity Awareness Month
Fact of the Day
Day 11

Q: A preemie I know needs heart surgery for a heart murmur. Is that common?
A: It depends on what is going on, but if it is for a PDA it is actually not that uncommon.

A PDA, or patent ductus arteriosus is an open ductus near the heart that should have closed prior to or just after birth. It doesn't close in many preemies, and that impacts the flow of blood to their lungs and decreases the efficiency of their circulatory system.

Here's an official website about it.

Here's how I understand it.  It's actually a genius little device, that PDA. In-utero it causes less blood to go to the lungs, as blood to the lungs isn't needed in the womb, and makes the whole system more efficient. Post-birth if it doesn't close on its own, pressure changes cause it to send MORE blood to the lungs, and things don't work as well as they should.

The doctors will try first to close the PDA with medicine. If that doesn't work, they'll discuss what steps to take next. They may let the baby grow until it is clear that the PDA is either causing problems or won't close on its own later. Or they may try to fix it earlier. It's a difficult choice for doctors, and we are glad they take this on a case-by-case basis.  Our team of neonatologists was split. Some liked the idea of getting it taken care of on JAM, others had a wait-and-see approach. Surgery on babies, even relatively routine surgery like a PDA, is risky. Finally, for our son, the situation "presented itself" and it was clear that he needed better blood flow.

You can read our PDA story as it unfolds herehere, here and here.

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