Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicans, diagnosis of persistent PDA and determination of its clinical and hemodynamic significance are challenging. Method: Prospective observational study of 152 neonates with gestational age {u2264} 34 weeks in which clinical parameters (prenatal: maternal risk factor, use of corticosteroid, mode of delivery. perinatal: gestational age, birth weight, Apgar score, gender. postnatal: heart rate, wide pulse pressure, blood pressure, oxygen therapy, blood gases, lactate level. outcomes; sepsis, apnea, NEC,IVH,BPD, pulmonary haemorrhage and echocardiographic parameters(duct size, left atrium /aortic ratio).the clinical and echocardiographic parameters analyzed were considerd statistically significant when P<0.05. Result: In the 152 neonates, the incidence of PDA was 87 (57.2%): (54(62.1%) non HSPDA and 33(37.9%) HSPDA) that received medical treatment (paracetamol 15mg/kg/6hr IV for 3 days) follow up Echo done at day 7 of life showed 20(68,9%) cases after 1st course,4 died before the day of follow up, 9 cases received 2nd course paracetamol. follow up Echo showed 4(13.7%) cases closed, 5 cases failed closure assigned for surgical ligation. the group of non HSPDA show spontaneous closure after conservative treatment. no PDA group was 65 (42.8%) that showed 2 reopened PDA.co-morbidities such as sepsis, pulmonary hemorrhage significantly associated to PDA and HSPDA groups. mortality was higher in HSPDA group than non HSPDA group

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