Specific features of the clinical manifestations of patent ductus arteriosus in extremely premature newborns

Abstract

Objective: to establish the clinical and functional characteristics of extremely premature newborn infants with patent ductus arteriosus and prognostic criteria for its function after 72 hours of postnatal life to determine a differentiated treatment policy for this category of patients. Sixty-nine extremely premature neonates with very low (n=37) and extremely low (n=32) birth weight and patent ductus arteriosus were followed up. Physical, neurological, laboratory, and instrumental examinations were performed. It was established that hemodynamically significant patent ductus arteriosus was detectable in 79.7% of the cases on day 3 of life, in 50.9% on day 5, and in 15.9% at the end of the neonatal period. Specific features were found in these patients compared to patients with hemodynamic insignificant patent ductus arteriosus. They showed a lower gestational age, lower Apgar scores, neurological disorders, moist rale, and crepitation, an increased lung pattern due to interstitial and vascular components, as well as a propensity to have thrombocytopenia, the significantly higher mean values of the diastolic and systolic diameters of the left ventricle, left atrium, right ventricle, and aortic root. A procedure was developed to predict a poor trend in patent ductus arteriosus. Conclusion. Taking into account the clinical and functional characteristics of extremely premature neonatal infants permits the longterm persistence of patent ductus arteriosus to be predicted in them, which is of importance in defining a therapeutic policy.