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We do not use it, due to two main reasons. 

1. We had few serious side effect such as: intestinal perforation

2. The drug is not available anymore in Israel

We are now practicing IVH prophylaxis measurements such as: delayed cord clamping, temperature stability, 4 hand treatment, insertion of umbilical lines to avoid IV punctures, volume guarantee ventilation etc.. and the IVH prevalence seems to decrease, therefore no need of INDO.  

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We use it in extreme circumstances: male preterm <700 g with no antenatal steroids who's had a vaginal unexpected birth. Sadly, ER-born extremely preterm births are becoming an issue in our hospital in the new COVID times. Prenatal care was perceived by some families as a risk factor during most of 2020.

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