Prostaglandin E1 treatment of congenital heart disease: use prior to neonatal transport

Prostaglandin E1 (PGE1) is used to maintain the patency of the ductus arteriosus in neonates when it is necessary to circumvent a defect in the heart or aorta in order to provide adequate peripheral perfusion. It has recently been recommended that medical stabilization with PGE1 be done as soon as a ductus-dependent cardiac defect is suspected, preferably prior to transport of the infant to a tertiary care center for surgical repair of the defect. To accomplish this, hospitals providing obstetric services will need to maintain a supply of PGE1. This commentary provides guidelines for determining the need to stock PGE1 and presents a brief review of the physiology of the ductus arteriosus and the pharmacology and adverse effects of PGE1 therapy.