Patent ductus arteriosus (PDA) is a common finding in newborns (NB), especially in extreme preterm infants. There are few publications about the impact and approach of this condition in infants > 28 weeks of gestation.
Verify the management and impact of PDA in preterm infants > 30 weeks of gestation and term neonates.
A retrospective study including all NB ≥ 30 weeks of gestation admitted to a level 3 Neonatal Intensive Care Unit with PDA was conducted. Data were collected from clinical records between January 2010 and December 2018. NB with congenital cardiopathy were excluded.
The final sample of 105 NB was divided in two groups:
30 to 33 weeks + 6/7 days (n=64): In 48.4% of the cases echocardiography was performed due to a heart murmur. A hemodynamically significant PDA (HS-PDA) was found in 22 cases and 13 were treated with ibuprofen. At the time of hospital discharge 32 maintained a restrictive PDA compared with only 2 cases at the 6-month follow-up review.
Late preterm and term NB (n=41): Echocardiography was performed mainly due to a heart murmur (41.5%), prenatal suspicion of cardiac anomalies (14.6%) or clinical deterioration (12.2%). HS-PDA was found in 7 cases, one treated with ibuprofen. At the 6-month follow-up review 2 patients maintained a restrictive PDA while 2 needed surgical ligation.
In moderate and late preterm and in term infants HS-PDA mainly presents with a heart murmur. This condition is usually managed with fluid restriction leading to a good clinical outcome.