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J Perinat Med. 2005;33(2):161-4.

Comparison of clinical criteria with echocardiographic findings in diagnosing PDA in preterm infants.

Author information

1
Department of Pediatrics, New York Methodist Hospital, Brooklyn, New York 11215, USA. ves9003@nyp.org

Abstract

OBJECTIVE:

The purpose of our study was to compare clinical criteria with echocardiographic findings in diagnosing hemodynamically significant patent ductus arteriosus (PDA) in preterm infants.

METHODS:

We evaluated 25 preterm infants born at 24-32 weeks of gestation with birth weight from 500 to 1700 g for tachycardia, heart murmur, hyperdynamic chest, presence of dorsalis pedis pulse, hypotension, and worsening of the respiratory status at 48-72 h of life. A pediatric cardiologist blinded to clinical findings performed the echocardiograms. Infants with congenital anomalies and conditions, sepsis, IVH, and necrotizing enterocolitis were excluded.

RESULTS:

Out of 25 preterm infants, 12 infants had hemodynamically significant PDA with left-to-right shunt. Two infants had small PDA and in 11 infants the ductus arteriosus was not patent. PDA infants had lower gestational age (P = 0.02) and birth weight (P = 0.03). Their Apgar scores (1 min) were lower (P = 0.03). The heart rate between the two groups differed, but was clinically within normal limits. Systolic (P = 0.05) and mean blood pressures (P = 0.04) were lower in the PDA group. A poor association between heart murmur, hyperdynamic chest and dorsalis pedis pulse, and the presence of PDA was revealed.

CONCLUSION:

Echocardiogram is required for early diagnosis of PDA in preterm infants, as clinical signs are not reliable in the first few days of life.

PMID:
15843268
DOI:
10.1515/JPM.2005.030
[Indexed for MEDLINE]

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