[Echocardiographic screening vs. symptomatic diagnosis for patent ductus arteriosus in preterms]

The persistence of ductus arteriosus, the aim of this study is to evaluate the possible benefit in the treatment for ductus closure when an early (less than 72 hours of life) echocardiographic screening is done versus when the echocardiographic diagnosis is realized only in present of associated symptoms.

Preterm without malformation followed by two strategies: patent ductus arteriosus (PDA) screening or echocardiographic study on suspected PDA for symptoms (control group). We analyzed the ductus characteristics, the presence of pulmonary hypertension and the treatments for their closure. We analyze the result in relation of the premature age as late preterm (34 to 36 gestational age weeks), moderate (30 to 33) and extreme (< 30).

There was no difference in the proportion of newborns diagnosed with PDA among the strategies (screening 18.6 % [101/543] vs 18.1 % [55/304], p = 0.92). In the control group, 53 % were diagnosed after 72 hours of life. There were no differences in relation of the ductus characteristic among the groups. The closure treatment were similar in the two strategies among the moderate and late preterm, but was more aggressive in the control group in the extreme preterms.

The echocardiographic screening for PDA in extreme preterm newborns reduces the time to detect it, and allow to give less aggressive treatment. We do not recommend their use in moderate o late preterm newborn.