To Go Against Nature: Manipulating the Neonatal Ductus Arteriosus with Prostaglandin

First observed by two gynecologists, Kurzrok and Lieb, a substance found in semen was named prostaglandin by VonEuler of the Karolinska Institute, with the assumption that it was produced by the prostate gland (Clin Perinatol. 1995;22:457–477). Endogenous prostaglandins PGE2 and prostaglandin I2 are produced within the ductus arteriosus lumen during gestation to keep the ductus patent (Semin Perinatol. 1987;11:64–71). Practitioners can prolong the patency of the ductus arteriosus in neonates with ductal-dependent congenital heart defects through the use of injectable prostaglandin. In 1981, the Food and Drug Administration approved Alprostadil, injectable prostaglandin E1, for use in the treatment of neonates with congenital heart disease (Drug Intell Clin Pharm. 1982;16:823–832). This article will review the role of prostaglandin in intrauterine and extrauterine life, as well as the pharmacology, adverse effects, drug interactions, and nursing implications associated with prostaglandin E1 use.