Article Text

MANAGEMENT STRATEGIES OF THE PATENT DUCTUS ARTERIOSUS IN PRETERM NEWBORNS
  1. N Drazdienė1,
  2. R Vankevičienė1
  1. 1Center of Neonatology, Vilnius University Medical Faculty, Vilnius University Children Hospital, Vilnius, Lithuania

Abstract

Objective To assess therapeutic strategies of PDA.

Methods We studied 1555 preterm infants admitted from 2002 to 2007 to our centre. 395 preterm newborns were very low gestational age (less than 30 weeks). PDA was assessed by clinical signs and confirmed echocardiographically. A significant PDA was defined by left atrium aortic root ratio >1.4 or a ductal diameter of >1.5–2.0 mm with left-to-right shunt. All infants received indomethacin in three intravenous doses in 24 hours intervals.

Results A hemodynamically significant PDA was diagnosed in 137 preterm infants (8.8%). 105 infants (76.6%) were less than 30 weeks, 52 (37.9%) infants less than 26 weeks. More than 30 weeks consisted of just 2.7% of preterm infants. The occurrence of PDA was frequent on the 6th–10th day of life. The treatment was effective for most of the newborns when using indomethacin. The surgical closure of PDA was used for 22 (16%) preterm infants. All of the operated newborns were less than 30 weeks of gestation. Mortality rate in the medical treatment group was 13%, in the group with surgical ligation 4.5% (one infant died after surgical closure of PDA because of the infection complication).

Conclusions Indomethacin was successful in closing the ductus arteriosus in 115 (83.9%) of the patients. All infants who needed surgery had a gestation age of less than 30 weeks.

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