Prostaglandins, ductus arteriosus, pulmonary circulation: Current concepts and clinical potential

Abstract

Research in the past few years has established that prostaglandins, specifically prostaglandin (PG) E₂, are responsible for keeping the ductus arteriosus patent in the fetus. Another prostaglandin, PGI₂, is likely involved in the pulmonary vasodilation occurring at birth. This knowledge has afforded a new approach in the management of several pathological conditions of the newborn. PGE₂ and structurally related PGE₁ are currently used in newborns with congenital heart lesions requiring patency of the ductus to maintain the pulmonary or systemic circulation. Conversely, inhibitors of prostaglandin synthesis are used for closing a patent ductus in the premature infant. Preliminary experience indicates that PGI₂ can be useful in the treatment of pulmonary hypertensive disorders of the neonate.