Which medication should be used to maintain ductus arteriosus patency in a neonate with ductal-dependent cyanotic heart disease?

• A. Indomethacin
• B. Prostaglandin E1
• C. Surfactant
• D. Nitric oxide

Answer: (B)

Maintaining ductus arteriosus patency is crucial when a newborn’s heart condition depends on the ductus for ensuring adequate blood flow to the lungs or body. Prostaglandin E1 (alprostadil) keeps the ductus open by relaxing smooth muscle in the ductus arteriosus, preventing its premature closure and preserving circulation until definitive repair or palliation can be performed. This makes it the appropriate choice to support a ductal-dependent cyanotic defect. Indomethacin (and similar NSAIDs) actually promote ductal closure, which would worsen the condition. Surfactant addresses respiratory distress and isn’t used to affect the ductus. Nitric oxide helps lower pulmonary vascular resistance but does not maintain ductal patency.