Indomethacin and fetal ductus arteriosus: Complete closure after cessation of prolonged therapeutic course

Yehuda Ben-David, Mordechai Hallak, Avi Rotschild, Yoram Sorokin, Ron Auslender, Haim Abramovici

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Indomethacin is a very effective tocolytic agent. However, concern about its possible constrictive effect on fetal ductus arteriosus has limited the use of this medication in pregnancy. A 29-year-old woman was treated with indomethacin at 27 weeks of gestation for preterm labor and polyhydramnios. She received a dose of 75 mg/day for 5 weeks. At 35 weeks of gestation, she had a cesarean delivery due to fetal distress, and a hydropic baby was delivered. The infant died shortly after. Nonimmune hydrops fetalis and closed ductus arteriosus were the only pathological findings at autopsy. In utero, irreversible, complete closure of the ductus arteriosus is very rare. In the case presented, prolonged use of indomethacin during pregnancy was associated with complete closure of the ductus arteriosus that developed most probably after discontinuation of therapy. This case emphasizes the need for frequent fetal echocardiography examinations during as well as after maternal indomethacin treatment.

Original languageEnglish
Pages (from-to)341-344
Number of pages4
JournalFetal Diagnosis and Therapy
Volume11
Issue number5
DOIs
StatePublished - 1 Jan 1996
Externally publishedYes

Keywords

  • Anatomical closure
  • Ductus arteriosus
  • Indomethacin
  • Polyhydramnios
  • Preterm labor

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