Usefulness of oral Indomethacin for Patent Ductus Arteriosus in Full-Term Neonates.

ABSTRACT

Background   Indomethacin is an effective treatment to close patent ductus arteriosus(PDA) in preterm neonates, and has been used for many years. Management of patent ductus arteriosus (PDA) in full-term neonates remain controversial. Recently, usefulness of indomethacin for patent ductus arteriosus in full-term neonates was reports. Objective     To evaluated the effectiveness of oral indomethacin for patent ductus arteriosus (PDA) in full-term neonates.Setting     Surin hospitalStudy design    Descriptive retrospective studyMethod Review of pediatric patient data admitted during 1st January to 31th December 2009.Result  The patient were 43 full-term neonates with PDA . All neonates were \> 2  days-old and has a gestation age  \> 37 weeks. Patient with ductus-dependent congenital heart disease, severe pulmonary hypertension(gradient \> 40 mmHg), respiratory failure or sepsis were excluded. The echocardiography evaluation was done confirm the diagnosis. The patient received indomethacin suspension (o.2mg/kg/dose. 3 dose12 hours apart). Of the 43 neonates, 33 (76.7%) showed complete closure, and 10 (233%) showed no closure. Statistical analysis revealed no difference between the two groups regarding GA, Birth weight, Apgar score at 1 minute, minimum diameter of the DA before treatment, the average age at the initiation of treatment. There was no significant difference in blood urea nitrogen, creatinine levels or thrombocyte counts in either group before and after treatment with indomethacin (p \> 0.05). No serious adverse reaction was observed in all neonates. Conclusion   This study showed the efficacy medical treatment of oral indomethacin for earlier closure of PDA in full-term neonates. Keywords  Patent ductus arteriosus, oral indomethacin, Gestational age. Echocardiography, Full-term neonates