Controversies in the Management of Patent Ductus Arteriosus in Preterm Infants

Patent Ductus Arteriosus (PDA) is present in 40-60 percent of preterm infants with its incidence inversely proportional to the gestational age. Management of PDA in extreme prematurity and extremely low birth weight infants is controversial specially with newer literature showing no significant benefits in long term outcomes in infants who were treated as compared to those who were not treated. Further the mortality and morbidities in preterm infants may not be entirely related to PDA as previously ascribed. Hence there is controversy as to which preterm infants benefit from treatment, when should they be treated and which treatment modalities should be used. We have reviewed the current literature to bring out the controversies in the answer to these questions.