A 6-week-old preterm baby born at 30 weeks has persistent tachycardia, bounding pulses, and a continuous machinery murmur below the left clavicle. What is the FIRST-LINE medical treatment for this condition?
- A Furosemide
- B Alprostadil (PGE1)
- C Indomethacin ✓
- D Digoxin
Correct answer: C. Indomethacin
Explanation
The clinical picture is consistent with patent ductus arteriosus (PDA) in a preterm infant. The ductus arteriosus remains open due to elevated local prostaglandin levels in preterm neonates. Indomethacin (a COX inhibitor) reduces prostaglandin synthesis and promotes ductal closure; ibuprofen is an alternative. Alprostadil (PGE1) is used to MAINTAIN ductal patency in duct-dependent lesions. Surgical ligation is reserved for failed medical therapy.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.