Outcome and Complication Rates of PDA Clipping and Ibuprofen/Indomethacin in The Neonates at Prapokklao Hospital
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Abstract
Background: The primary closure of the ductus arteriosus is typically completed on the first day after birth, although it may be delayed for several days. Ontogenic differences in physiological factors almost certainly account for the higher incidence of persistent patency of the ductus arteriosus (PDA) in preterm infants. The incidence of PDA in preterm newborns is 18-77%. Aggressive, urgent treatment of a significant PDA is required if there are signs of congestive heart failure. The use of oral Ibuprofen or intravenous Indomethacin to constrict the PDA has led to successful nonsurgical closure in about 60-80% of interventions. If medical treatment is unsuccessful or not possible, surgical closure can be performed with 1-5% mortality.
Objectives: To study and perform data collection about the efficacy and adverse reactions of Ibuprofen/Indomethacin and surgical PDA closure at Prapokklao Hospital.
Materials and methods: Cross-sectional study. We included all newborns with PDA from June 1, 2017 to March 31, 2018. The collected data included demographic data, echocardiography, comorbidity, and management strategies. A prospective analysis was conducted about outcomes and adverse reactions of each treatment strategy including medication and surgical PDA closure.
Results: The incidence of PDA in preterm infants is 9.4% and higher than full-term newborns (1.6%). Successful treatment with Ibuprofen/Indomethacin was demonstrated to be as high as 78.5%. Overall incidences of transient side effects were 11.4%. This study confirms both to be excellent and successful treatments with 0% mortality.
Conclusion: Successful treatment with Ibuprofen/Indomethacin was demonstrated to be as high as 84.6% with low side effects. Surgery now can be performed with minimal morbidity and mortality.
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References
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