Practice for Patent Ductus Arteriosus in Late Preterm and Full Term Infants; A Single Center Experience

Abstract

Abstract Background The arterial ductus is a major communicative pathway which is naturally patent in the fetus. Although usually closing on its own, it may remain open in the second postnatal week due to a lack of prompt diagnosis or absence of prompt treatment. Methodology In this observational study, 40 full term and late preterm neonates who have been diagnosed with patent ductus arteriosus (PDA) were recruited from the Neonatal Intensive Care Unit, Ain Shams University over a period of 6 months. The diagnosis of PDA was established both clinically (hemodynamic state) and by echocardiography. The enrolled neonates were observed to evaluate PDA treatment decisions (either ibuprofen, paracetamol or conservative management). Results We found significant increased PDA size before treatment in patients who had taken either ibuprofen or paracetamol (2.59 ± 0.59) for treatment of PDA when compared with those who had received no treatment (1.75 ± 0.16) (p = 0.001). In addition, we found significantly longer capillary refill time before treatment in patients treated by ibuprofen (2.2 ± 0.4) when compared to those who were treated by intravenous paracetamol infusion and the third group who received only conservative management (2.7 ± 0.7) (p = 0.026). However, we found no significant difference between the three groups as regard the final outcome (PDA closure, complications, survival and duration of NICU stay) (p- > 0.05). Conclusions Our findings showed that choosing certain treatment for closing PDA in our NICU depended mainly on clinical assessment of the baby and PDA size. And, that conservative management of PDA did not compromise survival and is not associated with increased morbidities in near term and full term neonates.