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  • Original Article
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Early echocardiographic prediction of ductal closure in neonates ⩽30 weeks gestation

Journal of Perinatology volume 33, pages 45–51 (2013)Cite this article

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Abstract

Objective:

To determine the accuracy of the patent ductus arteriosus:left pulmonary artery ratio (PDA:LPA) on echocardiogram (ECHO) at 3-day postnatal in predicting spontaneous PDA closure in neonates ⩽30 weeks gestational age (GA).

Study Design:

ECHOs were performed at 72 h to characterize PDA size as closed-to-small (PDA:LPA <0.5) or moderate-to-large (PDA:LPA ⩾0.5) and at 10 days to determine spontaneous closure (defined as closed-to-small in the absence of medical and/or surgical treatment). Caretakers were blinded to results; treatment was based on standard care. Neonates were prospectively enrolled and stratified: <27 weeks (n=31) and 27 to 30 weeks (n=65).

Result:

Neonates <27 weeks with closed-to-small PDAs had 60% spontaneous closure vs 9% when moderate-to-large (positive predictive value (PPV) 60%, negative predictive value (NPV) 91%). Neonates 27 to 30 weeks had 95% spontaneous closure vs 27%, respectively (PPV 95%, NPV 73%). Inter-observer variability for the initial ECHO was 0.84.

Conclusion:

PDA size defined by PDA:LPA at 3 days postnatal in combination with GA predicts spontaneous PDA closure.

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Acknowledgements

We thank Rong Huang, PhD, who helped with the biostatistical analysis of this study. Dr Rosenfeld is the recipient of the George L MacGregor Professorship in Pediatrics.

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Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center at Dallas, Children's Medical Center of Dallas, Dallas, TX, USA

    P P Thankavel & C Ramaciotti

  2. Department of Pediatrics, Neonatal-Perinatal Medicine, UT Southwestern Medical Center at Dallas, Dallas, TX, USA

    C R Rosenfeld & L Christie

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  1. P P Thankavel
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  2. C R Rosenfeld
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  3. L Christie
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  4. C Ramaciotti
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Correspondence to C Ramaciotti.

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Thankavel, P., Rosenfeld, C., Christie, L. et al. Early echocardiographic prediction of ductal closure in neonates ⩽30 weeks gestation. J Perinatol 33, 45–51 (2013). https://doi.org/10.1038/jp.2012.41

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