Prostaglandins, ductus arteriosus, pulmonary circulation: current concepts and clinical potential

Research in the past few years has established that prostaglandins, specially prostaglandin (PG) E2, are responsible for keeping the ductus arteriosus patent in the fetus. Another prostaglandin, PGI2, is likely involved in the pulmonary vasodilation occurring at birth. This knowledge has afford a new approach in the management of several pathological conditions of the newborn. PGE2 and structurally related PGE1 are currently in newborns with congenital heart lesions required patency of the ductus to maintain the pulmonary or systemic circulation. Conversely, inhibitors of prostaglandin synthesis are used for closing a patent ductus in the premature infant. Preliminary experience indicates that PGI2 can be useful in the treatment of pulmonary hypertensive disorders of the neonate.