title: Management of patent ductus arteriosus in preterm infants.
abstract: OBJECTIVE
  To evaluate the incidence of symptomatic patent ductus arteriosus (PDA) in preterm infants, and the results of the intravenous indomethacine treatment and surgery.
  
  
  METHODS
  Among 394 preterm infants (<37 weeks), symptomatic PDA was diagnosed by echocardiography in 51 babies and they were examined retrospectively. All infants were managed conservatively and then IV indomethacine was given to non-responders (n=30). Surgical closure was performed in 12 babies.
  
  
  RESULTS
  The incidence of symptomatic PDA in preterm infants was 12.9%: median age: 3 days, mean birth weight: 1434+/-540 g (540-2900g) and mean gestational age (GA) 30.9+/-3.3 weeks (23-37 weeks). With indomethacine, ductal closure was achieved in 70% infants. Early clinical improvement was observed in all cases that underwent surgery and most of them had a low birth weight (<1500 g) and an early gestational age (<32 weeks). None of them died due to operation.
  
  
  CONCLUSIONS
  The incidence of symptomatic PDA is high in preterm infants. Treatment with indomethacine improves ductal closure and is associated with few reversible adverse effects. In the other hand, early clinical improvement and high success rate were achieved after surgery. If indomethacine fails to achieve ductal closure, decision of surgery must be made immediately.
authors.affiliation: Department of Pediatric Cardiology, Faculty of Medicine University of Ankara, Ankara, Turkey. filizekici@yahoo.com
authors.forename: Filiz
authors.initials: F
authors.lastname: Ekici
authors.forename: Begüm
authors.initials: B
authors.lastname: Atasay
authors.forename: Ayla
authors.initials: A
authors.lastname: Günlemez
authors.forename: Nazire
authors.initials: N
authors.lastname: Naçar
authors.forename: Ercan
authors.initials: E
authors.lastname: Tutar
authors.forename: Semra
authors.initials: S
authors.lastname: Atalay
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Eyileten
authors.forename: Adnan
authors.initials: A
authors.lastname: Uysalel
authors.forename: Saadet
authors.initials: S
authors.lastname: Arsan
mesh_terms: D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007213:Indomethacin / Q000009:adverse effects / Q000627:therapeutic use*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008026:Ligation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D007213:Indomethacin