To Go Against Nature: Manipulating the Neonatal Ductus Arteriosus with Prostaglandin

Abstract 

First observed by two gynecologists, Kurzrok and Lieb, a substance found in semen was named prostaglandin by VonEuler of the Karolinska Institute, with the assumption that it was produced by the prostate gland (Clin Perinatol. 1995;22:457–477). Endogenous prostaglandins PGE₂ and prostaglandin I₂ are produced within the ductus arteriosus lumen during gestation to keep the ductus patent (Semin Perinatol. 1987;11:64–71). Practitioners can prolong the patency of the ductus arteriosus in neonates with ductal-dependent congenital heart defects through the use of injectable prostaglandin. In 1981, the Food and Drug Administration approved Alprostadil, injectable prostaglandin E₁, for use in the treatment of neonates with congenital heart disease (Drug Intell Clin Pharm. 1982;16:823–832). This article will review the role of prostaglandin in intrauterine and extrauterine life, as well as the pharmacology, adverse effects, drug interactions, and nursing implications associated with prostaglandin E₁ use.

Keywords: Prostaglandin, Ductus arteriosus, Neonate, Congenital heart disease, Cardiac