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“Silent” Patent Ductus Arteriosus and Bronchopulmonary Dysplasia in Low-Birthweight Twins

Published online by Cambridge University Press:  01 August 2014

V. Zanardo*
Affiliation:
Department of Pediatrics
D. Trevisanuto
Affiliation:
Department of Pediatrics
C. Dani
Affiliation:
Department of Pediatrics
O. Milanesi
Affiliation:
Department of Pediatrics
A. Guglielmi
Affiliation:
Department of Pediatrics
F. Cantarutti
Affiliation:
Department of Pediatrics
*
Dipartimento di Pediatria, Università di Padova, Via Giustiniani, 8, 35128 Padova, Italia

Abstract

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During a screening protocol of early echocardiographic diagnosis (ATL MK 600) and treatment of “silent” PDA in RDS preterms with BW ≤ 1.750 kg, clinical data on premature twins were collected, including diagnosis of both PDA and BPD, to investigate whether twin birth influences PDA incidence and BPD development. Out of the 290 RDS preterms evaluated, 96 (33%) showed evidence of PDA, and a total of 79 (27%) developed BPD, 47 (16%) with associated PDA and 32 (11%) without PDA. Out of 238 singletons, 74 (31%) presented “silent” PDA and a total of 75 (31%) developed BPD, 44 (18%) with associated PDA, and 31 (13%) without PDA. In 52 other twins (18% of the total number of babies studied), 22 (42% of this subgroup) presented evidence of “silent” PDA, and 4 (8% of the subgroup), developed BPD, 3 with associated PDA (6% of the subgroup), and 1 without PDA (2% of the subgroup). From these data, it is inferred that that low-birthweight twins are at high risk for PDA hemodynamic complications during RDS, and may benefit from early induced ductal closure. Instead, in RDS twins, BPD was statistically less frequent (at the 99% C.L.) probably because twinning enhances fetal lung maturity, influencing enzymatic and nonenzymatic protective systems of lung defence.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1993

Footnotes

* National Institute for Nuclear Physics, Padua University, Italy

References

REFERENCES

1. Bancalari, E, Sosenko, I (1990): Pathogenesis and prevention of neonatal chronic lung disease: recent development Pediatr Pulmonol 8:109119.CrossRefGoogle Scholar
2. Bleker, OP, Brever, W, Huidekoper, BL (1979): A study of birthweight placental weight and mortality of twins as to singletons. Brit J Obstet Gynecol 86:111118.CrossRefGoogle ScholarPubMed
3. Brown, E, Stark, A, Sosenko, I, Lawson, EE, Avery, ME (1979): Bronchopulmonary dysplasia: a possible relationship to pulmonary edema. J Pediatr 92:982984.CrossRefGoogle Scholar
4. Burn, J, Corney, G (1984): Congenital heart defects and twinning. Acta Genet Med Gemellol 33:6169.Google ScholarPubMed
5. Chiswich, ML (1976): Prolonged ruptures of membranes, pre-eclamptic toxaemia and respiratory distress syndrome. Arch Dis Child 51:674679.CrossRefGoogle Scholar
6. Clyman, RI, Campbell, D (1987): Indomethacin therapy for patent ductus arteriosus: when is prophilaxis not prophylactic? J Pediatr 111: 718722.CrossRefGoogle Scholar
7. Dudell, GC, Gersony, WM (1984): Patent ductus arteriosus in neonates with severe respiratory disease. J Pediatr 104:915918.CrossRefGoogle ScholarPubMed
8. Gersony, WM, Peckham, GJ, Lang, P, Talner, NS, Lerer, TJ, Lin, L, Dooley, KJ, Nadas, AS (1983): Effect of indomethacin in infants with patent ductus arteriosus. Results of a national collaborative study. J Pediatr 102:895906.CrossRefGoogle ScholarPubMed
9. Guglielmi, A, Galeazzo, A, Trevisanuto, D, Dani, C, Zanardo, V (1992): Perinatal data computerization. Med Surg Ped 14:3444.Google Scholar
10. Heldt, GP, Pesonen, E, Merritt, TA (1989): Closure of the ductus arteriosus and mechanics of breathing in preterm infants after surfactant replacement therapy. Pediatr Res 24:305310.CrossRefGoogle Scholar
11. Kallen, B (1986): Congenital malformations in twins: a population study. Acta Genet Med Gemellol 35:167178.Google ScholarPubMed
12. Nylander, PPS (1979): Perinatal mortality in twins. Acta Genet Med Gemellol 28:363368.Google ScholarPubMed
13. O'Brodovich, HM, Mellins, RB (1985): Bronchopulmonary dysplasia. Am Rev Respir Dis 132:694709.Google ScholarPubMed
14. Persson, PH, Grennert, L, Gennser, G, Kullander, S (1979): On improved outcome of twin pregnancies. Acta Obstet Gynecol Scand 53:37.CrossRefGoogle Scholar
15. Wigglesworth, JS, Desai, R, Aber, V (1987): Quantitative aspects of perinatal lung growth. Early Hum Dev 15:203212.CrossRefGoogle ScholarPubMed
16. Zanardo, V, Foti, P, Trevisanuto, D, Zambon, P, Stellin, G, Milanesi, O (1989): Does the respiratory distress syndrome in twins and singletons run different risks of persistent ductus arteriosus? Acta Genet Med Gemellol 38:315318.Google ScholarPubMed
17. Zanardo, V, Milanesi, O, Trevisanuto, D, Rizzo, M, Ronconi, M, Stellin, G, Cantarutti, F (1991): Early screening and treatment of “silent” patent ductus arteriosus in prematures with RDS J. Perinat Med 19:291293.Google Scholar