Comparison of Efficacy of Oral Ibuprofen versus Paracetamol for PDA Closure in Preterm Neonates

Objective: The aim of this study is to compare the efficacy of oral ibuprofen versus paracetamol for PDA closure in preterm neonates. Study Design: Randomized Control trial Place and Duration: The study was conducted at Neonatology department North West General Hospital, Peshawar for duration of three years from April 2018 to March 2021. Methods: Total one hundred and fifty preterm neonates were included in this study. Patients' detailed demographics including gestational age, gender; birth and diameter were recorded after taking informed written consent from the parents. Patients were equally divided into two groups, I and II. Group I had 75 patients and received paracetamol for closure for patent ductus arteriosus and group II received oral ibuprofen for closure of PDA. Outcomes among both groups were calculated in terms of effectiveness, mortality and post-operative complications. Data was analyzed by SPSS 22.0 version. Results: Mean gestational age of the patients in group I was 29.12 +/- 7.44 weeks and in group II mean gestational age was 30.09 +/- 4.66 weeks. 45 (65%) male in group I and in group II 40 (53.3%) were male babies. Mean ductal diameter in group I was 3.02 +/- 1.13 and in group II mean diameter was 2.98 +/- 0.16 mm. In group I cesarean birth was found in 50 (66.7%) and in group II 48 (64%) cesarean birth was found. Mean duration of closure was lower in group I 4.24 +/- 1.03 days as compared to group II 5.01 +/- 0.03 days. PDA closure rate was higher in group I 62 (82.7%) and in group II its frequency was 58 (77.3%). Re-opening of ductus was found in 6 (8%) in group I and 8 (10.7%) in group II. Adverse outcomes were renal failure, hyperbilirubinemia and gastrointestinal bleeding among both groups. Mortality rate in ibuprofen group was higher 7 (9.3%) as compared to group I 4 (5.3%). Conclusion: We concluded in this study that the use of drug paracetamol is effective for the closure of PDA in preterm neonates as compared to oral ibuprofen with less adverse outcomes and mortality rate.