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


CONCLUSIONS
Echocardiogram is required for early diagnosis of PDA in preterm infants, as clinical signs are not reliable in the first few days of life.
Alagarsamy
Sukirtha
S
Department of Pediatrics, New York Methodist Hospital, Brooklyn, New York 11215, USA. ves9003@nyp.org
Chhabra
Manoj
M
Gudavalli
Madhu
M
Nadroo
Ali M
AM
Sutija
Vesna G
VG
Yugrakh
Dorina
D
D001794:Blood Pressure; D003430:Cross-Sectional Studies; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011446:Prospective Studies