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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

Takeshi Takami
1   Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
,
Hitoshi Yoda
2   Department of Neonatology, Toho University, Tokyo, Japan
,
Takehiko Ishida
3   Department of Neonatal and Premature Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
,
Shinichiro Morichi
1   Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
,
Atushi Kondo
1   Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
,
Daisuke Sunohara
1   Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
,
Akinori Hoshika
1   Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
,
Tadashi Kawakami
3   Department of Neonatal and Premature Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

14 April 2012

27 July 2012

Publication Date:
12 November 2012 (online)

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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
 

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