A neonate born with congenital rubella is diagnosed of having patent ductus aeriosus (PDA). What is the most common cause of death in this condition?
The ductus aeriosus is a fetal communication between the descending aoa just distal to the left subclan aery and the main pulmonary aery near its bifurcation. A patent ductus aeriosus (PDA) occurs when the ductus aeriosus fails to close after bih. With a PDA, congestive hea failure (CHF) can occur because of chronic left hea volume overload. In patients with death related to PDA, CHF is the most common cause. Development of right-left shunt is also a poor prognostic indicator. Risk factors for PDA include maternal rubella infection, bih at high altitude, premature bih, female sex, and genetic factors. In infants born at less than 28 weeks of gestation, there is 60% incidence of PDA. Impoant Note In the fetus, the ductus aeriosus is maintained open by low aerial oxygen content and placental prostaglandins. Ref: Manual of Cardiovascular Medicine edited by Brian P. Griffin, Eric J. Topol, Deepu Nair, M.D., Kellan Ashley, M.D., 2008, Page 458 ; Nelson Textbook of Paediatrics 17th edition, Page 1611
Cardiac failure
Respiratory failure
Infective endaeritis
Embolization