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Dr. Matthew Laughon, Professor at University of North Carolina and NICHD Neonatal Research Network investigator, presents the landmark PDA Management Trial comparing expectant management versus active medical treatment (indomethacin, ibuprofen, or acetaminophen). The trial stopped early due to futility and safety concerns—mortality exceeded 10% in the treatment group versus 4% with expectant management, with more infection-related deaths among treated infants. Secondary outcomes (BPD, NEC, ROP) showed no differences. The study included infants with symptomatic PDAs but excluded those with severe cardiopulmonary compromise. Findings support expectant management for symptomatic PDAs through 21 days of life, aligning with recent guidelines recommending no routine treatment in the first two weeks.
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