Management of patent ductus arteriosus in preterm infants.
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.
Ekici
Filiz
F
Department of Pediatric Cardiology, Faculty of Medicine University of Ankara, Ankara, Turkey. filizekici@yahoo.com
Atasay
Begüm
B
Günlemez
Ayla
A
Naçar
Nazire
N
Tutar
Ercan
E
Atalay
Semra
S
Eyileten
Zeynep
Z
Uysalel
Adnan
A
Arsan
Saadet
S
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
D002317:Cardiovascular Agents; D007213:Indomethacin