TF Yeh

Abstract

Patent ductus arteriosus (PDA) occurs frequently in premature infants. The overall incidence of clinical PDA reported in premature infants ranges from 18 to 80%. However, the incidence of clinical and subclinical PA detected by echocardiography can be as high as 90%. Significant PDA L→R shunt can complicate the clinical course of RDS, therefore significant PDA requires medical or surgical intervention. Although pharmacological or surgical closure of the ductus may be required, in some infants PDA may close spontaneously without specific therapy. Management of subclinical PDA remains controversial. Routine prophylactic use of indomethacin, either for prevention of PDA or IVH cannot be recommended at the present time until more follow up studies are available. Surgical ligation of the ductus may be indicated in infants who do not react to medical treatment, particularly infants of extreme low birth weight. This paper summarizes the diagnosis and the current management. Emphasis has been placed on pharmacological closure of the ductus using the prostaglandin inhibitor.