Brief Answer:
Kindly give few more details

Detailed Answer:
Hi XXXXXXX
I understand your concern

Kindly give me few more details for a more clear clinical picture:
1. Her birth weight.
2. Is she on ventilator?
3. Surfactant therapy given(injection instilled directly to lung to promote lung expansion)?
4. What exact heart complication was communicated- is it heart failure or something else?
5. Finally, kindly attach reports, including ECHO report, and if possible, chest X ray(no reports visible to me)

PDA is a common issue in premature babies(born before date) with low birth weight. But, unlike in a term baby(born after date), PDA in preterm babies have high chance of spontaneous closure(>90%). Most of the times, PDA per se is not life threatening.

Treatment options of PDA includes drugs, endoscopic procedures(endo-vascular) and surgery. Very few babies need treatment(those with persisting breathing difficulty or heart failure). Surgery is very rarely needed.


Kindly get back with details, so that I can guide you better
Take care

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Brief Answer:
Need not worry

Detailed Answer:
Hi XXXXXXX
Thanks for sharing the reports.

The ECHO report mentions mainly 3 problems- PDA, ASD and Pulmonary hypertension. With present clinical status, these do not require emergency intervention.
1. PDA most probably will close spontaneously in few weeks. If dopamine requirement continues and shunting through PDA progresses in serial ECHO tests, your doctor may attempt closure with drugs. Surgery is needed very rarely for PDA

2. ASD also can close spontaneously. Since it is small, it should not be a cause of concern now. ASDs persisting beyond 1 year is usually closed by endoscopic procedure(device closure)

3. Pulmonary hypertension is very common in newborn period, and hopefully will come down gradually in serial ECHOs. If persisting, your doctor might start drugs like Sildenafil to lower pressure, but needed rarely.

Apart from this, baby have shock(low blood pressure), respiratory distress and few dysmorphic features.

Shock is responding to Dobutamine, and hopefully she will come out of this. Depending on reports of sepsis screen, baby might need antibiotics too.

Respiratory distress also we expect to come down as shock and pulmonary hypertension resolves.

In view of dysmorphic features(ear tags, finger shape), baby might need genetic testing which your doctor will discuss with you.

In short, although there are multiple issues, and baby is a bit critical now, she is gradually improving. Listen carefully to your doctor, as condition might change rapidly during initial 3-4 days. Let us hope for the best.

Let me know if I can assist you further
Wishing for a faster recovery
Dr Muhammed Aslam, Paediatrician

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