P0404 - PDA in Southern Puerto Rico. Rate, Treatment, and outcomes, of PDA in Patients Admitted to Level IV Referral NICU covering the Southern Population of Puerto Rico

The ductus arteriosus (DA) is a crucial component of fetal circulation. Before birth, approximately 90% of right ventricular output bypasses the lungs and flows through the DA towards the placenta, where gas exchange will occur. Its patency is crucial to life, its closure equals death. After birth, however, the DA is supposed close as blood now flows to the lungs for oxygenation. A Persistent Ductus Arteriosus is defined as failure of the DA to close within 72 hours after birth. PDA is associated with significantly worse outcomes with rates of morbidity and mortality in untreated infants that approach 30%. Despite this, no study of the rate of PDA in the southern population of Puerto Rico had been done. Using a retrospective review of patient records from Saint Luke's Episcopal Hospital, the only level IV NICU, and the largest referral center in the area, we isolated a period of 30 months, during which there were 4246 live births. Of these 51 patients had a diagnosis of PDA. Records of all 51 patients were reviewed for information about Gestational Age, Weight, Time to Follow Up, Treatments and Therapies, and Patient Outcomes. Doppler Color Echocardiography images taken were reviewed with Pediatric Cardiologist to determine Grade, Flow, and Clinical significance. This information gave us an idea about the frequency of PDA in live births in southern Puerto Rico and a picture of the state of the current diagnosis and treatment of PDA at Saint Luke's Episcopal Hospital. The results of this retrospective analysis were used to optimize and adjust diagnostic imaging and treatment regimens for patients with PDA. Preliminary data has already shown improvement in time to follow up and closure rates in newborns identified to have PDA.