24th INTERNATIONAL CONGRESS OF PEDIATRICS

CANCUN, MEXICO AUGUST 15 – 20, 2004

RESEARCH PAPER

Title: EFFECTS OF MEFENAMIC ACID IN TERM INFANTS WITH HEMODYNAMICALLY

SIGNIFICANT PATENT DUCTUS ARTERIOSUS
Author(s): Lee SL, M.D.1, Kim CS, M.D.1, Sin JB, M.D 2, Byun SH, M.D 3, Hwang CH, M.D4,
Chung KH, M.D 5, Kim JS, M.D1, and Kwon TC, M.D 1
Institution: Dept. of Pediatrics, Dongsan Medical Center, Keimyung University 1, Busan Paik
Hospital 2, Joey Children’s Hospital 3, Mogpo Hansarang Hospital 4, and Hyundai
Hospital 5
Address: 194, Dongsan Dong, Daegu, Korea (Zip Code: 700-712)
Tel: 82-53-250-7535 Fax: 82-53-250-7537
Email: Isl@dsmc.or.kr
OBJECTIVE: Mefenamic acid is a prostaglandin synthase inhibiter, like indomethacin, and used for the
closure of hemodynamically significant patent ductus arteriosus (hsPDA) in premature infants. This
study was performed to evaluate the effect of mefenamic acid (MA) in full-term infants with hsPDA.

DESIGN: Among full-term infants with hsPDA who were admitted to NICU of Dongsan Medical Center,
Keimyung University during the period from July 1999 to June 2003 were enrolled in this study. The
diagnosis of hsPDA was made by clinical (Modified Yehs criteria>3, and need for artificial ventilation)
and echocardiographic findings (LA/Ao>1.49), and was not closed within 72 hours of life to rule out
functional PDA. Among 23 cases, 13cases were treated with lasix plus mefenamic acid (MA group),
and the other 10 cases were treated with lasix (control group). The dosage of MA was 2 mg/kg, every
12 hours, 3 times given via OG tube. Follow up echocardiographic examinations were done every week
until PDA was closed. The rate of PDA closure and clinical courses of both groups were compared.
Comparisons of quantitative data were made by Students two-tailed t-test, those of binomial data were
made by the chi-square test and Mann-Whitney test. This study was approved by the Institutional
Review Board and Human Ethics Committee, and informed cosent was obtained prior to randomization.

RESULTS: Mean birth weight, sex, initial cardiothoracic ratio and LA/Ao ratio findings were similar
between both groups. Mean weeks of closure was occurred significantly shorter in MA group (1.5 wks)
than that of control group (3.4 wks) (p<0.01). The closure rate within 2 weeks after therapy was
significantly higher in MA group (92.3%) than that of control group (30%) (p<0.01), significant
complications were not identified in MA group. None in MA group was needed surgical ductal ligation,
but 20% in control group (p>0.1).

CONCLUSION: Mefenamic acid can be used as an effective drug for the early closure of
hemodynamically significant PDA in fullterm infants without any significant side effects, and slightly
reduce the need for ductal ligation.

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