Effects of Indomethacin on Patent Ductus Arteriosus in Neonates with Genetic Disorders and/or Congenital Anomalies

Takeshi Takami; Hitoshi Yoda; Takehiko Ishida; Shinichiro Morichi; Atushi Kondo; Daisuke Sunohara; Akinori Hoshika; Tadashi Kawakami

doi:10.1055/s-0032-1329185

American Journal of Perinatology, Table of Contents

Am J Perinatol 2013; 30(07): 551-556
DOI: 10.1055/s-0032-1329185

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of Indomethacin on Patent Ductus Arteriosus in Neonates with Genetic Disorders and/or Congenital Anomalies

Authors

Takeshi Takami

¹Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
Hitoshi Yoda

²Department of Neonatology, Toho University, Tokyo, Japan
Takehiko Ishida

³Department of Neonatal and Premature Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
Shinichiro Morichi

¹Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
Atushi Kondo

¹Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
Daisuke Sunohara

¹Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
Akinori Hoshika

¹Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
Tadashi Kawakami

³Department of Neonatal and Premature Medicine, Japanese Red Cross Medical Center, Tokyo, Japan

Abstract

Objectives The study aimed to evaluate the effectiveness of intravenous indomethacin (IND) therapy for patent ductus arteriosus (PDA) in neonates with genetic disorders and/or congenital anomalies soon after birth.

Study Design A total of 301 neonates with a genetic disorder and/or congenital anomalies and with a gestational age of ≥35 weeks were admitted during the study period. Eighty-five neonates with 56 genetic disorders (30 cases of trisomy 21, 10 cases of trisomy 18, and 16 others) and 29 congenital anomalies, and with clinical symptoms received intravenous IND therapy. The management methods were similar to those used for PDA in low-birth-weight infants.

Results IND therapy had a clinical benefit at a high rate of 79% in these patients (90% and 70% in neonates with trisomies 21 and 18, respectively), including complete closure of the PDA in 52% of the patients. Although oliguria was observed in 43 infants (51%) and slight gastrointestinal bleeding was observed in 12 (14%), no infants had severe complications such as intracranial bleeding.

Conclusions IND therapy is an effective treatment option before considering surgery for PDA in neonates with genetic disorders and/or congenital anomalies. This therapy may reduce the difficulty of treatment in the acute stage among these neonates.

Keywords

patent ductus arteriosus (PDA) - indomethacin - chromosome abnormality - trisomy 21 - trisomy 18

Full Text

References

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