When the doctors tell you that your newborn baby has a complex heart condition, it's hard to put into words the fear and shock you feel as a parent. On one hand, you feel sad and scared for your baby. On the other hand, you feel like you don't understand a single word the doctors are saying or the names of the medicines. At such times, one of the familiar names you will hear is 'Alprostadil.' So today, let's talk very simply and politely about what this medicine is, why it is given to babies, and what you need to know about it.
Why is this medicine given to a baby? Let's first understand this.
Before we talk about this medicine, we need to understand a little bit. Think about it, when the baby is in the mother's womb, his lungs don't work, right? He gets the oxygen he needs from the umbilical cord. So at this time, there is a small connection, like a 'bypass' path, between the blood vessel that carries blood from the heart to the lungs (Pulmonary Artery), and the main blood vessel that carries blood to the body (Aorta). This is what we call the Ductus Arteriosus . When the baby is born and starts breathing on his own, this 'bypass' path is no longer needed. So it closes on its own within a few hours. That is the normal process.
However, some babies are born with very complex heart defects (Congenital Heart Defects). For example, the blood vessel that carries blood to the lungs may not form properly, or there may be a difference in the way the main blood vessels are connected. In this case, if the 'bypass' path we talked about earlier called the Ductus Arteriosus becomes blocked, the baby's body and lungs will not receive enough oxygenated blood. This is very dangerous for the baby's life.
That's when doctors need to perform surgery to keep the 'bypass' path, the ductus arteriosus, artificially open until the heart problem is corrected. The life-saving drug given for this is called alprostadil.
So, what exactly is Alprostadil?
Simply put, alprostadil is a synthetic drug that is similar to a chemical called 'Prostaglandin' that is naturally produced in our bodies. It is most commonly used in our country under the brand name Prostin VR .
The main function of this is to stop the ductus arteriosus from closing and keeping it open. It's like putting a small stick in the middle of a door to keep it open. This medicine keeps the baby's body supplied with the blood it needs until the heart surgery. So this is a very important medicine, like a temporary bridge .
How do you give this medicine to a baby?
This is not a medicine to use at home. Alprostadil is given in a hospital, especially in a Neonatal Intensive Care Unit (NICU) or Pediatric Intensive Care Unit (PICU).
This is because this medicine must be given directly into a vein, like a saline solution (intravenous infusion) , very carefully, continuously. Also, while this medicine is being given, things like the baby's heart rate, blood pressure, and oxygen levels are monitored very closely by doctors and nursing staff 24 hours a day with special equipment. So remember that your baby is very safe.
Important things to inform the doctor
Before starting this medication, it is very important to discuss this information about your baby with your medical team. Usually, doctors will ask you this, but it is good for you to be aware of this as well.
- If the baby has a bleeding problem (for example, a condition where the blood does not clot easily).
- If the baby has any difficulty breathing .
- If you have previously shown an allergy to a medicine or food.
- If you have any other medical condition.
What are the possible side effects of this medicine?
Like any medication, alprostadil can cause some side effects. But don't worry, because the baby is in the intensive care unit, the staff is ready to identify and treat any of these immediately.
| Side Effect | What to know |
|---|---|
| Things to report to the doctor or nursing staff immediately | |
| Allergic Reactions | A skin rash, itching, swelling of the lips/tongue/face. |
| Breathing changes | Temporary cessation of breathing (Apnea), decreased or increased breathing rate. |
| Changes in heart rate or blood pressure | Decreased or increased heart rate, decreased blood pressure. |
| Fever | Increased body temperature. |
| Seizures | Body tremors or convulsions. |
| Flushing | Redness of the skin. |
| Things to inform the doctor if they persist | |
| Stomach ache | Diarrhea. |
| Pain where the medicine is given | Swelling or redness where the medicine was given into the vein. |
Remember, this list does not include all possible side effects. So if you notice any unusual changes in your baby's behavior or appearance, or if you have any concerns, tell the doctor or nurse immediately.
What to do if the medication dose is increased?
This is given in a hospital, by trained medical staff, using special machines (infusion pumps), so the chance of an overdose is very low. However, if you have any doubts, talk to the doctor or nurse taking care of your child immediately. For general information about any medicine or poisoning, you can call the National Poisons Information Centre at the Colombo National Hospital . In an emergency, you should go directly to the hospital's Emergency Treatment Unit (ETU) .
Take-Home Message
- Alprostadil is a temporary, life-saving medication given to newborns with congenital (born with) heart disease.
- Its main function is to keep a special blood vessel called the Ductus Arteriosus open until the baby's heart is operated on.
- This medicine is given in a hospital's intensive care unit, under the full supervision of doctors and nurses . So don't worry about the baby's safety.
- If you notice any unusual symptoms in your baby (such as fever, difficulty breathing, skin changes) while giving the medicine, notify the medical staff immediately .
- This medicine is not a permanent solution to the baby's heart problem. However, it is a very important bridge that prepares the baby for surgery, which is the permanent solution.
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