QuestionSBA
QuestionChoice
Diuretics have no role in the treatment of PDA, unless there is associated fluid overload.
10007224
d
Furosemide
QuestionChoice
ACE inhibitors have no role in treating PDA.
10007225
e
Ramipril
QuestionChoice
PDA is a condition whereby there is a failure of the ductus arteriosus to close after birth, allowing oxygenated blood from the descending aorta to flow back to the pulmonary artery. This subsequently leads to inadequate oxygenation and respiratory distress. Indomethacin inhibits prostaglandin synthesis which otherwise maintains the patency of the ductus arteriosus. The indomethacin therefore supports duct closure, often preventing the need for surgical intervention.
10007221
a
Indomethacin
QuestionChoice
This would maintain the patency of the ductus arteriosus. Sometimes this is desirable, for example when there is a right-to-left shunt and the PDA is necessary for oxygenated blood to mix. Prostaglandins are used here to keep it open until surgery is successful. However, prostaglandins are not used in the closure of a PDA.
10007223
c
Prostaglandins
QuestionChoice
This is only indicated if non-surgical management fails. In many cases, medical management through indomethacin is adequate to allow closure of the PDA.
10007222
b
Surgical management
Concept
Chapter
2693
4579
Patent Ductus arteriosus
Topic
153
Paediatrics
13991
A neonate born at 32 weeks gestation is reviewed by the paediatric team for respiratory distress. On examination she has a continuous heart murmur. An echocardiogram shows a patent ductus arteriosus (PDA).

Which of the following is the most appropriate first line treatment?
a