March 6, 2008

There is not much change today. All of the babies have a heart murmur, but is seems that Rylie has the loudest murmur. Rylie had an Echocardiogram today to evaluate the murmur. An echocardiogram is a method of using ultrasound to evaluate the structures of the heart and surrounding tissue. Rylie's echocardiogram showed that he has a Patent Ductus Arteriosis (often abbreviated PDA) . The Ductus Arteriosis is structure that allows shunting of blood between the pulmonary artery and the aorta; this is necessary during fetal development, but it should close after birth. If it fails to close, or if it fails to close completely, it is considered to be "patent" and therefore a Patent Ductus Arteriosis. There is a fairly decent explanation of ductus arteriosis function at:

http://en.wikipedia.org/wiki/Ductus_arteriosis

This site also explains some of the problems associated with a patent ductus arteriosis. A more complete explanation can be found at:

http://en.wikipedia.org/wiki/Patent_ductus_arteriosus

There are several treatment options. Nothing can be done, and the PDA should close on its own; but it may take a little time. It can be treated with Non-Steroidal Anti-Inflammatory Drugs (often abbreviated NSAIDs); the most common NSAID used is Indocin. NSAID's work by reducing prostaglandin synthesis. Prostaglandins are needed to keep the Ductus Arteriosis patent. This is why NSAIDs are not used in the third trimester of pregnancy, since it can cause premature closure of the Ductus Arteriosis. Right now we are waiting on the doctor to decide what treatment, if any needs to be done right now.

Reese continues to do well with her CPAP and feeds. Her bilirubin level continues to drop and she no longer needs to be under a blue light.

Ryan is still on a ventilator. He is still having thick lung secretions that need to be suctioned periodically. He is tolerating feeds well, and he is no longer getting phototherapy.