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Updated: Jul 29, 2026
10:52
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Patent ductus arteriosus: pathophysiology and management.
E R Hermes-DeSantis1, R I Clyman
1Drug Information Service, Robert Wood Johnson University Hospital, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, New Jersey, USA.
Summary
Patent ductus arteriosus (PDA) in preterm infants presents treatment challenges. This review explores evidence and experience on optimal timing for indomethacin intervention to manage PDA and associated comorbidities.
Area of Science:
- Neonatalogy
- Pediatric Cardiology
Background:
- Patent ductus arteriosus (PDA) is common in preterm newborns (<28 weeks gestation).
- PDA can lead to increased pulmonary blood flow and affect organ perfusion.
- Associated comorbidities include necrotizing enterocolitis, intracranial hemorrhage, and bronchopulmonary dysplasia, though causality is debated.
Purpose of the Study:
- To review evidence and clinical experience regarding treatment strategies for PDA in preterm infants.
- To discuss the optimal timing for intervention, contrasting early prophylaxis with treatment upon symptom manifestation.
- To explore the comparative physiology of PDA closure in term versus preterm neonates.
Main Methods:
- Review of existing evidence and clinical experience.
- Discussion of prostaglandin inhibitor efficacy, specifically indomethacin.
- Analysis of physiological differences between term and preterm newborns concerning PDA closure.
Main Results:
- Indomethacin is an effective treatment for PDA.
- The optimal timing for intervention remains a significant clinical challenge.
- Understanding physiological barriers to PDA constriction in preterm infants is crucial.
Conclusions:
- Optimal timing for PDA intervention in preterm infants requires careful consideration of evidence and experience.
- Further research may clarify the causal role of PDA in neonatal comorbidities.
- Addressing PDA effectively is critical for improving outcomes in extremely preterm newborns.
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