What a Patent Ductus Arteriosus (PDA) Means for Your Baby
Key takeaways:
A patent ductus arteriosus (PDA) is a heart defect that some babies have after they are born.
Many times, babies don’t need any treatment because the patent ductus arteriosus closes on its own within a few days.
Some babies, especially premature babies, need treatment with either medication or surgery to help close the patent ductus arteriosus.
Congenital heart disease is a medical condition that develops when a child’s heart doesn’t form properly during pregnancy. There are many types of congenital heart defects, and one of the most common is a patent ductus arteriosus (PDA). PDAs are diagnosed soon after a baby is born because they often cause a loud heart murmur. But a PDA isn’t always a cause for concern. Here’s what you should know about PDAs and what it could mean for your baby.
What is patent ductus arteriosus?
A PDA happens when the ductus arteriosus remains open after a baby is born.
The ductus arteriosus is a blood vessel that connects two major blood vessels: the pulmonary artery and the aorta. During pregnancy, the ductus arteriosus allows oxygen-rich blood to flow directly from the placenta to the fetus’s body without passing through the lungs.
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But once a baby is born and they start to breathe air, they need blood to pass through the lungs to pick up oxygen and deliver it to the rest of their body. As soon as a baby takes their first breath, the body starts sending signals that prompt the ductus arteriosus to clamp down and close off.
If the ductus remains open after birth, it’s called a PDA. Not all PDAs are a cause for concern. Some PDAs are very narrow. They may take extra time to close but don’t cause any health problems. Other PDAs are wider and can impact an infant’s health.
What causes patent ductus arteriosus?
It’s not clear.
It normally takes up to 72 hours after birth for the ductus arteriosus to completely close. So, for the first few days of life, a baby might have a murmur because of a PDA. This doesn’t usually cause any health problems because the vessel closes by itself quickly.
Other times, it takes a PDA longer to close off. But if the PDA is narrow, it may not impact your baby’s health at all.
But sometimes, the PDA is wide and doesn’t close after a few days. This can lead to serious health problems. Babies with these types of PDAs need treatment.
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Babies who are born early (prematurely) are more likely to have a PDA that needs treatment. But babies may also be more likely to have a PDA that needs treatment if they have:
A genetic condition
Fetal distress during late pregnancy or delivery (signs the baby isn’t well, usually due to oxygen levels)
An infection that started during pregnancy (like rubella)
Another congenital heart defect
What are the symptoms of patent ductus arteriosus?
Many babies with a PDA may only have a heart murmur, which is an extra sound during the heartbeat.
Bigger and wider PDAs can lead to serious health effects on the heart and lungs. Babies may even need help breathing and feeding. Without treatment, babies can develop heart failure too.
How is patent ductus arteriosus diagnosed?
A PDA causes a harsh murmur that healthcare professionals can identify by listening to a baby’s heart with a stethoscope.
Your baby will need further testing to confirm the diagnosis of a PDA. This can include a:
Chest X-ray to view your baby’s heart size and whether their lungs are clear
EKG to measure the electrical activity of the heart and look for evidence of heart enlargement
Echocardiogram (ECHO), an ultrasound of the heart that shows the structure of the heart in more detail
How is a patent ductus arteriosus treated?
Babies with narrow and small PDAs do not need any treatment. Your baby’s primary care provider or cardiologist may want to see your child more frequently to make sure their murmur goes away and that they aren’t developing signs of heart failure, trouble breathing, or poor weight gain.
But if your baby has a PDA that is leading to other problems, they will need treatment. A PDA can be treated in several ways.
Medications
An anti-inflammatory medicine called indomethacin can be used to help close the PDA. The medicine is most effective in premature babies, so it may not be recommended if the baby is full-term. Indomethacin stimulates the PDA to tighten and close off.
Catheterization
This is the most common treatment for PDA. It is done by a specialist called an interventional cardiologist. During the procedure, a small incision is made near a blood vessel in the leg. A small, flexible tube called a catheter is then threaded through the blood vessel to the PDA, where a plug or coil is inserted into the PDA to close it off.
Surgery
Surgery is usually only performed if the PDA is very large. This procedure is done by a pediatric heart surgeon under general anesthesia. An incision is made in the chest and the PDA is closed with stitches or small metal clips.
The bottom line
A PDA is a congenital heart condition that is usually diagnosed soon after birth. Most PDAs close on their own within a few days. Small, narrow PDAs don’t usually cause any symptoms or health problems. Larger PDAs do need to be treated with medications, catheterization, or surgery. Treatment prevents health complications.
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References
Eilers, L. F., et al. (2021). Patent ductus arteriosus. Pediatrics in Review.
Gillam-Krakauer, M., et al. (2023). Patent ductus arteriosus. StatPearls.
Nemours Children’s Health. (2023). Cardiac catheterization.
Thomson, J. (n.d.). Patent ductus arteriosus (PDA).
University of California San Francisco. (n.d.). Patent ductus arteriosus.
