[Maternal and neonatal effects of indomethacin administrated during pregnancy. Apropos of 18 cases].

Abstract

BACKGROUND:

There have been several reports that prolonged exposure of pregnant women to indomethacin for tocolysis may have significant pharmacological effects on the fetus or newborn.

PATIENTS:

Eighteen pregnant women were given indomethacin during the year 1989 for treatment of premature labor (n = 16) or polyhydramnios (n = 2). Treatment was started at gestational week 28.1 +/- 2.5 and was discontinued at gestational week 30.7 +/- 1.8. The mean age of the women at the onset of pregnancy was 30.6 +/- 5.3 years. The daily dose of indomethacin was initially 200 mg (2-3 mg/kg), then 107 +/- 59 mg. The cumulative dose was 1,820 +/- 2,370 mg. The duration of treatment was 18.1 +/- 16.4 days (less than 7 days in 8 women).

RESULTS:

The term at delivery was 33.4 +/- 3.3 weeks (11 after 32 weeks). The mean interval between discontinuation of treatment and delivery was 19.0 +/- 18.7 days. Indomethacin was effective in 10 cases of premature labor, and gestation was prolonged by 52.6 +/- 19.2 days. Among the 23 live-born neonates, 5 developed renal insufficiency attributed to indomethacin (4 premature labor, 1 hydramnios). The kidney failure with early hyperkalemia was cured within about 7 days in 4 cases. The remaining neonate also suffered from severe prolonged hypoxia and died on day 4.

CONCLUSIONS:

Administration of indomethacin for premature labor places the fetus at risk because of the short drug-free interval before birth. High daily or cumulative doses of indomethacin dit not result in adverse effects.

• Authors: E Jacqz-Aigrain, M Guillonneau, C Boissinot, F Bavoux, J F Hartmann, P Blot
• Journal: Archives francaises de pediatrie (Arch Fr Pediatr) Vol. 50 Issue 4 Pg. 307-12 (Apr 1993) ISSN: 0003-9764 [Print] France
• Vernacular Title: Effets maternels et néonatals de l'indométacine administrée pendant la grossesse. A propos de 18 observations.
• PMID: 8379817 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Indomethacin

Topics

• Adult
• Female
• Humans
• Indomethacin (adverse effects, therapeutic use)
• Infant, Newborn
• Male
• Obstetric Labor, Premature (prevention & control)
• Polyhydramnios (prevention & control)
• Pregnancy
• Renal Insufficiency (chemically induced)