This study looks at how different ways of handling a symptomatic patent ductus arteriosus (sPDA) affect premature babies. The sPDA is an open blood vessel in the heart that should close after birth. In this study, doctors will either actively treat the sPDA with medicine (indomethacin or ibuprofen) or wait and see if treatment is needed. The goal is to see which approach helps more babies survive without developing a lung condition called bronchopulmonary dysplasia (BPD), which can affect breathing. The study will finish when the babies are 36 weeks old if they were still in their mom's tummy. The doctors will decide if any surgery is needed during the study. To join, babies must be between 2 days and 3 weeks old and born very early. Babies with certain heart or lung problems can't participate.

• Study checks if waiting reduces death or BPD by 10%.
• Treatment uses medicine, and surgery is decided by the doctors.
• Babies must be born between 22 and 28 weeks to join.