Early echocardiographic prediction of ductal closure in neonates ≤30 weeks gestation

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20 Scopus citations

Abstract

Objective:To determine the accuracy of the patent ductus arteriosus:left pulmonary artery ratio (PDA:LPA) on echocardiogram (ECHO) at 3-day postnatal in predicting spontaneous PDA closure in neonates ≤30 weeks gestational age (GA).Study Design:ECHOs were performed at 72 h to characterize PDA size as closed-to-small (PDA:LPA <0.5) or moderate-to-large (PDA:LPA ≥0.5) and at 10 days to determine spontaneous closure (defined as closed-to-small in the absence of medical and/or surgical treatment). Caretakers were blinded to results; treatment was based on standard care. Neonates were prospectively enrolled and stratified: <27 weeks (n=31) and 27 to 30 weeks (n=65).Result:Neonates <27 weeks with closed-to-small PDAs had 60% spontaneous closure vs 9% when moderate-to-large (positive predictive value (PPV) 60%, negative predictive value (NPV) 91%). Neonates 27 to 30 weeks had 95% spontaneous closure vs 27%, respectively (PPV 95%, NPV 73%). Inter-observer variability for the initial ECHO was 0.84.Conclusion:PDA size defined by PDA:LPA at 3 days postnatal in combination with GA predicts spontaneous PDA closure.

Original languageEnglish (US)
Pages (from-to)45-51
Number of pages7
JournalJournal of Perinatology
Volume33
Issue number1
DOIs
StatePublished - Jan 2013

Keywords

  • ductus arteriosus
  • extremely low birth weight
  • neonatal morbidities
  • sensitivity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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