A study of efficacy of oral indomethacin in treatment of PDA closure in neonates
Naik, Ronak (2004) A study of efficacy of oral indomethacin in treatment of PDA closure in neonates. Masters thesis, Gujarat University.
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Objective: To study the incidence of PDA in neonates and amongst other CHD’s. To study effect of oral indomethacin in closure of PDA where it is not contraindicated in neonates, irrespective of size of ductus on 2D echo along with other measure like oxygen and fluid restriction wherever needed. To study the complication due to indomethacin therapy. Design: Prospective study. Methods: All the neonates born between March 2001 to March 2003 at V.S. General Hospital, Ahmedabad were screened for PDA by 2D echo and trial was done on 40 patients as per dosage schedule defined by guidelines of National Collaborative study. Results: Incidence of PDA is 2.68 per 1000 live births and amongst other CHD’s is 29.41%. Out of 40 patients 57.5% were preterm and 42.5% were fullterm. Incidence is highest in 1500-1999gms wt. group in preterm then it declines. In 96% of preterms and 70% of fullterms diagnosis was done within 1st four days of life. Overall 83.78% patients had responded. While 100% preterms irrespective of gestational age and birth weight only 60% fullterms had responded. 91.66% patients had responded when drug was started with in 7 days of life, and 70% when after 7 days of life with 100% sensitivity for preterms in both the groups. Only 10% patients had altered renal function without oliguria or renal failure. No other complications were observed. Conclusion: Oral indomethacin is safe, easily available, cheap and very effective with convenient dosage schedule and predictable pharmacokinetics use of which prevents surgical intervention, due expenses and complications related to surgery. Thus oral indomethacin can be advocated in all the preterms with PDA irrespective of gestational age and birth weight.
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