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Effect of prostaglandin-E1 treatment on pyloric wall thickness in newborns with ductal-dependent critical congenital heart diseases

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Abstract

Background

Prostaglandin E1 (PGE1) is used in the medical treatment of ductal-dependent critical congenital heart disease (CCHD) in neonates. Apnea/bradycardia, hypotension, hypokalemia, and fever are the most important side effects of PGE1. Moreover, gastric outlet obstruction has been reported in a few case reports. A prospective study was conducted to investigate the effect of PGE1 treatment on pyloric wall thickness in newborns with congenital heart diseases.

Methods

A total of 22 newborns with ductal-dependent CCHD having PGE1 infusion longer than a week were included in this study. Ultrasonographic measurements were performed before and one week after the PGE1 infusion to evaluate the pyloric thickness and length. The protocol was registered with ClinicalTrials.govidentifier NCT04496050.

Results

A total of 22 neonates with mean gestational age 38 ± 1.8 weeks and birth weight 3105 ± 611 gr were enrolled in the study. The median time of the second ultrasound was seven days. The median cumulative dose of PGE1 given during this period was 108 mcg/kg/min. There was a statistically significant increase in post-treatment pyloric thickness and length compared to pre-treatment measurements (p < 0.001, p < 0.001). None of the patients with increased thickness and pyloric muscle length presented any symptoms.

Conclusion

PGE1 treatment significantly increased the pyloric thickness and length after at least one-week treatment. PGE1 with its action mechanism is likely to cause gastric outlet obstruction, although not exactly pyloric stenosis on the condition used for a long time.

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It can be shared if desired (data transparency).

Code availability

Not applicable.

Abbreviations

NICU:

Neonatal intensive care unit

PGE1:

Prostaglandin E1

US:

Ultrasound

CCHD:

Critical congenital heart diseases

DA:

Ductus arteriosus

PDA:

Patent ductus arteriosus

CH:

Cortical hyperostosis

HPS:

Hypertrophic pyloric stenosis

TGA:

Transposition of great arteries

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Funding

No external funding was received for this manuscript. The authors have indicated they have no financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Hacettepe University, Ankara, Turkey

    Umit Ayşe Tandircioglu, Sule Yigit & Hasan Tolga Celik

  2. Faculty of Medicine, Department of Pediatric Surgery, Hacettepe University, Ankara, Turkey

    Ozlem Boybeyi Turer & Tutku Soyer

  3. Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Hacettepe University, Ankara, Turkey

    Ercan Ayaz & H. Nursun Ozcan

Authors
  1. Umit Ayşe Tandircioglu
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  2. Ozlem Boybeyi Turer
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  3. Tutku Soyer
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  4. Ercan Ayaz
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  5. H. Nursun Ozcan
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  6. Sule Yigit
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  7. Hasan Tolga Celik
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Contributions

Study conception and design: UAT, HTC, TS, OBT. Data acquisition: UAT, EA, HNO. Analysis and data interpretation: UAT, HTC, SY. Drafting of the manuscript: UAT, SY, OBT, HNO, EA, HTC, TS. Critical revision: UAT, SY, HTC, TS.

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Correspondence to Umit Ayşe Tandircioglu.

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Hacettepe University Interventional Ethics Committee decision number: 2020/14-18 (include appropriate approvals or waivers).

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Tandircioglu, U.A., Turer, O.B., Soyer, T. et al. Effect of prostaglandin-E1 treatment on pyloric wall thickness in newborns with ductal-dependent critical congenital heart diseases. Pediatr Surg Int 39, 144 (2023). https://doi.org/10.1007/s00383-023-05428-8

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