Question about prostaglandin inhibitors in PDA?

[jat20]

In class yesterday, we learned about congenital heart diseases. Our instructor told us that prostaglandin helps the ductus arteriosis close in a normal heart at birth. Then she said prostaglandin inhibitors are used to promote closure in a PDA.

Can someone explain how this makes sense?

Thanks!!

[meanmaryjean, DNP, RN]

Your instructor misspoke. Prostaglandins maintain ductal patency. Anti-prostaglandins (such as indocin) trigger closure.

Fun Fact #1: I worked on the drug trials for PGE1 in the 1980s.

Fun Fact #2: How the connection between prostaglandins and the ductus arteriosus was discovered was a rash of stillborns in mothers who took Indocin (a powerful prescription strength NSAID used to treat arthritis back in the day)

[jat20]

Awesome! Thank you!!

[KelRN215, BSN, RN]

When understanding congenital heart disease, also keep in mind that there are some congenital heart defects where you don't want the PDA to close. For example, in hypoplastic left heart syndrome, babies are starting on intravenous prostaglandin at birth to prevent the PDA from closing before they have their Norwood procedure. Someone I went to high school with had a baby earlier this year who was born with undiagnosed HLHS. By the time they'd figured it out, only days after birth, he had global hypoxic brain damage (because his PDA had closed) and his parents decided not to pursue cardiac surgery.

[jat20]

We also learned that prostaglandins may be given in pulmonic stenosis. This is because we want the ductus to stay open so some blood will flow from the aorta into the pulmonary artery to get re-oxygenated until further treatment can be done.