Patent ductus arteriosus (PDA) is one of the most common congenital heart defects occurring in some babies soon after birth. Normally, the fetus blood circulation includes a connection between the aorta and the pulmonary artery via a blood vessel known as the ductus arteriosus. After birth, the circulation matures by closing the ductus arteriosus within few days. If the ductus arteriosus remains open (patent), the blood will flow directly from the aorta into the pulmonary artery causing a strain on the heart and increase the blood pressure in the lung arteries. The incidence of PDA is estimated to be 1:2000 full term infants; however, the rate is higher in premature babies.
Clinical signs include failure to gain weight, frequent chest infections, heavy breathing during mild physical exertion, congestive heart failure, and pulmonary edema, however, many patients remain asymptomatic. Initial diagnosis is made by detecting the characteristic heart murmur and this can be supported by chest X-ray, echocardiograph, and ECG.
Treatment depends on the size of PDA, the symptoms, and pregnancy period. PDA has shown self correction in some cases. Preterm infants with PDA will receive certain medication to close the ductus arteriosus. On the other hand, if the preterm infant doesn't respond to the medication and in the case of full term infant, surgery will be the effective option.
Hammoud et al. (2003) studies 101 consecutive ventilated preterm infants in Kuwait to study the incidence and risk factors of patent ductus arteriosus (PDA) in this population. Of these 101 infants, 53.4% were found to have PDA. Regression analysis revealed maternal diabetes, antepartum hemorrhage, low gestational age, low birth weight, and male gender to be significantly associated with PDA in preterm infants with respiratory distress syndrome.
Almawazini and AlGhamdi (2011) screened 2610 children from Albaha region with congenital heart disease (CHD). Of these, 56 patients (9.5%) were found to have a PDA.
In 1998, Al Talabani et al. studied the pattern of major congenital malformations in 24,233 consecutive live and stillbirth at Corniche hospital, which is the only maternity hospital in Abu Dhabi, between January 1992 and January 1995. A total of 401 babies (16.6/1,000), including 289 Arabs, were seen with major malformation. Multifactorial disorders accounted for 26% of the cases. In their study, Al Talabani et al. (1998) observed six cases with patent ductus arteriosus in families from the United Arab Emirates. One of the patients was described to have ventricular septal defect. Recurrence was not reported in any of the families. Al Talabani et al. (1998) concluded that their study was very close to representing the true incidence of congenital abnormalities in the whole United Arab Emirates, as they investigated over 98% of deliveries in Abu Dhabi, the capital of United Arab Emirates.
Hosani and Czeizel (2000) evaluated the pilot dataset [March-May 1998] of the UAE National Congenital Abnormality Registry (NCAR). A total of 4,861 births were recorded in this study period, with a birth prevalence of total congenital anomalies being 30.3/1,000 births. Patent ductus arteriosus was identified in one neonate, resulting in an incidence rate of 0.21/1,000 births.