Patent ductus arteriosus and cerebral circulation in preterm infants

The diagnosis of patent ductus arteriosus (PDA) was determined by Doppler examinations of the descending aorta and/or main trunk of the pulmonary artery in a cohort of 120 preterm infants. 55 per cent of the infants had Doppler echocardiographic evidence of ductal patency on the first day of life and this proportion fell to 30 per cent on the second day and 21 per cent on the third day. The incidence remained constant for the rest of the first week. Infants with PDA were significantly more likely to develop periventricular leukomalacia (PVL) than infants without PDA, but the incidence of periventricular haemorrhage was not increased. The cerebral haemodynamic effects of ductal patency were evaluated. Infants with PVL were found to have a significantly higher incidence of retrograde flow in the anterior cerebral artery during diastole, but the study was unable to demonstrate any significant difference in cerebral blood flow velocity between the infants with and without PDA.