Use of prostaglandin in newborns with serious congenital heart disease

ABSTRACT

In a number of cardiac lesions the pulmonary or systemic circulation depends partially or totally on the patency of the ductus arteriosus. Ductal closure after birth could prove fatal in these cases of congenital cardiac lesions. In the early 1970s, research showed the efficacy of E type prostaglandins [PGE] in relaxing the ductus muscle. Clinical trials showed that PGE[1] or PGE[2] were consistently effective in increasing the oxygenation of newborns whose pulmonary blood flow was dependent on patency of the ductus arteriosus. In ductus-dependent systemic-flow lesions, PGE[1] also has shown its effectiveness. It improves acidaemia, oxygenation and provides an improved metabolic state for cardiac catheterization or surgery. Before transferring an infant with these lesions from a peripheral hospital, PGE[1] infusion can be started intravenously, in consultation with the paediatric cardiologist. The most frequent side-effect of PGE[1] or PGE[2] infusion is fever, and the most serious side-effect is apnoea. In general, side-effects diminish with decrease in infusion rate