What to do with a PDA?

JWilliams4 · April 2011

They found a large PDA in my little guy who is now 27wks but don't seem concerned because he is doing so well on CPAP (21% oxygen at 5peep) and they said we will just watch and wait to see if it closes on its own. Dr mentioned using Indomethacin (which coincidently is what kept me pregnant for awhile) but if it didn't work surgery would be another option. Has anyone experienced this and how was it handled? No one seems concerned right now except for Mama Bear

CLAYLIOVER · April 2011

Try not to let it worry you. My DD had a large PDA that eventually closed on its own and required no intervention. Just another bump on the ride. GL!

irishdo · April 2011

There is a relatively new (2009? 2010?) study out of Stanford that shows there is no need to treat the PDA unless it is causing other heart or lung issues. It was a pretty definitive study with impressive results. It is a total shift in thinking and treatment that even the neos are adjusting to. My son (24 weeks) had a large PDA but never required neoprofen or surgery. He had around a 5 day period where he needed increased vent support likely due to the PDA but was able to ride through it. It closed on its own without incident.

Good Luck!

kaylaaimee · April 2011

Out of the 6 PDA preemies born at our hospital in the past 5 months, Scarlette was the only one who needed surgery b/c it was restricting blood flow to her intestines. The rest of the babies closed up after one or two courses of indocin (sp?)

PDAs are very common in preemies but most close without the need for surgery. If for some reason that becomes an option, feel free to ask me any ?s about it.

I know it's hard not to worry though.

mrsmacias2008 · April 2011

one of my twins had that and we were worried too. They had talked about meds and surgery. It's very common in preemies and usually closes up on it's own. Right before we got discharged, they had to check to make sure it closed and it did.

OscarQ · April 2011

Kevin had a PDA that was causing issues. His PDA didn't respond to the indocin (6 total doses over 2 rounds of treatment) and he evenually had the ligation surgery.

Ask them to reconsider if it isn't causing him any issues. While Kevin did well, there are side effects to the Indocin (that Kev luckily avoided) and there's always risk with the surgery as well as the recovery afterwards was rough. He got sicker after the surgery and he was already one of the sickest babies they'd ever done that surgery on at that hospital (thanks RT for telling me that - just what a mom wants to hear).

This blog had some info on the PDA - the parents had two preemies - https://preemieparenting.blogspot.com/2008/05/closing-pda.html

And here are some NICU nurses talking about using Ibuprofen vs. Indocine - one of them mentions the possible side effects of Indocine: https://allnurses.com/nicu-nursing-forum/pda-treatment-ibuprofen-195300.html

Edit: I don't mean to scare you about the side effects and the surgery risk. I certainly thought through both sets of risks and came to the conclusion that the medicine and surgery were best for my baby (I wasn't aware of the Ibuprofen option). Just putting the information out there so that you can review it with your doctors.

Natalie_may · April 2011

My "at home" baby has a large PDA and arterial septal defect. Since it wasn't causing him issues, he always satted well and moved through breathing interventions at a good pace. Indocin was not an option in our case as he had an ostomy and could not be on blood thinning medications. At discharge his echo was still irregular and the murmur is still present, we were sent home with instructions to follow it with the pedi and we have a cardiology appointment in two months. If it isn't causing problems try not to stress! If he does need the surgery down the road it is a very routine procedure, very uninvasive. Good Luck!

JakesBride07 · April 2011

Both of my lo's had PDA's. They watched and waited and then gave meds and both closed right up. They hVe had no problems since.

cara-n-steve · April 2011

Leland has PDA. Luckily now that he's full term its almost gone. Hopefully LO's will close too and he won't need surgery. When they found it they told me they want to wait it out til he reached full term, because they thought it would most likely close.

lemen99 · April 2011

Andrew's PDA was open too. I was on 2.5 rounds of indomethacin during pregnancy too (to help keep pregnant.)

The doctors told me that indomethacin would not be as effective in closing Andrew's PDA since he had been exposed to the drug in the womb. Instead, they opted for ibuprofen, and it worked, so we avoided surgery. I generally am one to trust my doctor, but you might ask about that option.

Prayers!

sandsandmore · April 2011

My 27w twins both have PDAs. They're now 37w, still in the NICU, and both still have large PDAs. They haven't done anything about them and probably won't.

ESM354 · April 2011

My DS had one too. At first they weren't going to do anything about it as it wasn't bothering him. Then he started having some different issues with his breathing and they thought the PDA could be to cause. They tried the steroids to see if that would help close it. They didn't help for us. In the end we decided the surgery was necessary. I was so worried about it but it didn't end up being that big of a deal. The surgeon went over the benefits and the risks with us before surgery. He came through surgery with flying colors and started doing better almost immediately with his breathing. Good luck with everything!

AVA0908 · April 2011

My DS was 26 weeks and had a PDA. Couldn't take meds because he had a level 3 IVH on one side of his brain. They had to operate and I was a nervous wreck, but the whole operation only took 10 minutes and he never had problems with it after that. He is almost 3 and completely fine.

I hope that your DS's PDA will eventually close up on its own and that he doesn't need surgery!

lemen99 · April 2011

AVA0908:
My DS was 26 weeks and had a PDA. Couldn't take meds because he had a level 3 IVH on one side of his brain. They had to operate and I was a nervous wreck, but the whole operation only took 10 minutes and he never had problems with it after that. He is almost 3 and completely fine.
I hope that your DS's PDA will eventually close up on its own and that he doesn't need surgery!

I'm curious about this because my son was a 26-weeker with a level 2 and level 4 IVH, and he took meds for his PDA that worked!

Cara03 · April 2011

ESM354:
My DS had one too. At first they weren't going to do anything about it as it wasn't bothering him. Then he started having some different issues with his breathing and they thought the PDA could be to cause. They tried the steroids to see if that would help close it. They didn't help for us. In the end we decided the surgery was necessary. I was so worried about it but it didn't end up being that big of a deal. The surgeon went over the benefits and the risks with us before surgery. He came through surgery with flying colors and started doing better almost immediately with his breathing. Good luck with everything!

This is pretty much our story, too. LO's improvement after surgery was drastic.

AVA0908 · April 2011

Really? I wish I would have known that! That is just what the doctors told us. There were several things that happened while DS was in the NICU that I would have changed if given another chance. Not saying that we didn't get good care, but I think as a non-medical professional, we just never thought to question a lot of things that they did especially since we had never experienced it before.

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