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Early echocardiographic prediction of ductal closure in neonates 30 weeks gestation.
MedLine Citation:
PMID:  22499084     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.Journal of Perinatology advance online publication, 12 April 2012; doi:10.1038/jp.2012.41.
Authors:
P P Thankavel; C R Rosenfeld; L Christie; C Ramaciotti
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-12
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  -     ISSN:  1476-5543     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center at Dallas, Children's Medical Center of Dallas, Dallas, TX, USA.
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