Management of symptomatic patent ductus arteriosus in very low-birth-weight infants

A retrospective study of 39 infants under 30 weeks' gestation was carried out to analyze the incidence, management, and morbidity resulting from symptomatic patent ductus arteriosus. Symptomatic patent ductus arteriosus developed in 21 (53.8%) infants. Eleven (52.3%) infants underwent surgical closure of the ductus. The infants in this group had lower birth weight and severe respiratory distress syndrome and higher morbidity, compared with the medically managed group. The infants who responded to medical management did not have higher morbidity compared with the control group who did not sustain symptomatic patent ductus arteriosus. Indomethacin treatment was not effective in infants with a birth weight less than 800 gm. Our findings indicate that the higher morbidity seen in the symptomatic patent ductus arteriosus group may be due to respiratory distress syndrome, surgery, and birth weight under 800 gm. Prophylactic use of indomethacin may have a doubtful value in this group.