623 Does Early Spontaneous Closure of the Ductus Arteriosus in Very Preterm Infants Predict Final Closure?

Abstract

Background: A patent ductus arteriosus (PDA) is a common problem in very premature infants. Echocardiography is the gold standard for diagnosis, although there is no agreement about a most discriminating parameter. Not much is known about the spontaneous closure of the duct. Reports concerning this issue differ widely.We investigated closure rate of PDA on day 2 after birth in premature infants with a gestational age ≤32 weeks.Methods: During a prospective cohort study on diagnosis of hemodynamic significant PDA we performed echocardiography at 3 standard time points (day 2,4 and 6 after birth) in 200 premature infants (GA ≤32 weeks).Results: In 70 patients (35%) the duct was closed on day 2 after birth. Gestational age and birth weight of this group was not different from the group (n=130 (65%)) in which the duct was still open. None of the the closed ducts on day 2 after birth reopened at a later point of time.Of the 130 patients with an open ductus ateriosus on day 2, 33 (16.5% of the total group) needed treatment.Conclusions: When the ductus arteriosus was closed on day 2 treatment for closure was never needed.We recommand to perform echocardiography on day 2 after birth in every very premature infant, to make a risk assessment for further clinical course.