Case Report - Current Pediatric Research (2024) Volume 28, Issue 2

Oral prostaglandin E1 derivative for maintaining systemic circulation in a neonate with duct-dependent congenital heart disease in a resource poor setting

Background: In neonates with duct dependent Congenital Heart Disease (CHD), the use of Prostaglandin E1 (PGE1) primarily in parenteral form to maintain the patency of the Ductus Arteriosus (DA) is lifesaving. In settings with limited resources where parenteral PGE1 is not routinely available, neonates with duct-dependent CHD are potentially fatal if surgical intervention is not immediately feasible. After conducting a thorough literature search, only three case reports of oral PGE1 use were found.

Case report: A Nigerian male infant was diagnosed with pulmonary atresia, sinus venosus atrial septal defect and a moderately sized Patent Ductus Arteriosus (PDA) on his fourth day of life. On the ninth day of life, he displayed signs of cardiogenic shock and a repeat echocardiogram on the tenth day of life revealed that the ductus arteriosus had shrunk. Due to inaccessibility of parenteral prostaglandin E1, oral prostaglandin E1 derivative (misoprostol) was administered every 4 hours via feeding tube. The patient's cardiovascular condition steadily stabilized, and on the 21st day of life, echocardiography revealed a large PDA.

Conclusion: Oral prostaglandin E1 was effective in maintaining the patency of the ductus arteriosus and could be used as a palliative treatment in settings with limited resources.

Author(s): Nwaneli Ifeyinwa Ezinne, Adiele Daberechi Kenneth*, Nwagboso Chimaobi, Nwaneli Chibundo Uchenna

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