Ductus arteriosus (DA) (DA)

The ductus arteriosus is a vital fetal blood vessel connecting the pulmonary artery to the proximal descending aorta, serving to shunt blood away from the non-functional fetal lungs (StatPearls, 2023). Under normal physiological conditions, the vessel closes shortly after birth due to rising oxygen levels and falling prostaglandin E2 concentrations (NIH, 2022). If the vessel remains open, it is termed a patent ductus arteriosus (PDA), which can lead to significant hemodynamic instability, pulmonary hypertension, and heart failure in neonates (Mayo Clinic, 2023). While the ductus arteriosus itself is an anatomical structure rather than a single molecule, it is the site of action for several pharmacological interventions. Cyclooxygenase inhibitors like ibuprofen and indomethacin are used to induce closure by blocking prostaglandin synthesis, whereas alprostadil (prostaglandin E1) is used to maintain patency in infants with certain congenital heart defects (PubMed, 2021). The management of this vessel is critical in neonatal intensive care, particularly for premature infants or those with ductal-dependent cardiac lesions. Recent research also explores the use of paracetamol (acetaminophen) as an alternative for ductal closure with potentially fewer side effects than traditional NSAIDs (Cochrane, 2020).

Other names

Botallo's ductDuctus BotalliPDA (when patent)

Inhibition of cyclooxygenase (COX) enzymes to reduce prostaglandin E2 levels (inducing closure) or administration of exogenous prostaglandin E1 (maintaining patency).