Related Experiment Videos
Reversible fetal hydrops associated with indomethacin use.
L Pratt1, J Digiosia, J N Swenson
1Department of Obstetrics and Gynecology, University of Wisconsin-Madison, 53715, USA.
Obstetrics and Gynecology
|January 5, 2002
Summary
Indomethacin can cause fetal hydrops and ductal constriction, even in singleton pregnancies. Early ultrasonographic screening is crucial for monitoring these risks during indomethacin therapy.
Area of Science:
- Perinatology
- Fetal Medicine
- Neonatology
Background:
- Indomethacin is a nonsteroidal anti-inflammatory drug used for tocolysis.
- Ductus arteriosus constriction is a known complication of in utero indomethacin exposure.
- Nonimmune hydrops has been rarely reported with indomethacin, primarily in twins over 32 weeks' gestation.
Observation:
- A case of fetal hydrops with tricuspid regurgitation and ductal constriction occurred in a 28-week singleton gestation.
- These complications developed within 30 hours of initiating indomethacin tocolysis.
- Partial resolution of findings was observed 72 hours after discontinuing indomethacin.
Findings:
- This case highlights that indomethacin-induced fetal hydrops and ductal constriction can occur in singleton gestations at an earlier gestational age.
- The rapid onset of symptoms underscores the potential toxicity of indomethacin.
- Discontinuation of the drug led to partial reversal of the observed fetal abnormalities.
Implications:
- Ultrasonographic screening for ductus arteriosus constriction should be implemented within 48 hours of starting indomethacin therapy.
- This monitoring is recommended regardless of gestational age or whether it is a singleton or twin pregnancy.
- Early detection and intervention can potentially mitigate severe fetal complications.