All non-steroidal anti-inflammatory drugs (
NSAIDs) are
prostaglandin inhibitors, which explains their foetal toxicity. So far, no epidemiological study of their cardiopulmonary and renal effects has been carried out, but case-reports have been published. The cardiopulmonary effects of
NSAIDs include closure of the ductus arteriosus,
pulmonary hypertension cardiopathy and
tricuspid valve insufficiency. They were responsible for 31 neonatal accidents, 8 of which were fatal (for 22 pregnant women, 7 bearing twins, 1 bearing triplets). The renal effects of
NSAIDs consisted of
acute renal failure with oedema,
oliguria, hyponatraemia and marked hyperkalaemia. They affected 23 neonates, 8 of whom died (for 17 pregnant women, 4 bearing twins, 1 bearing triplets). A few epidemiological studies have reported foetal haemorrhages when
aspirin was used by the mother as
anti-inflammatory agent. In comparative trials of
indomethacin as short treatment of premature labour and
polyhydramnios the
drug proved to be effective. In obstetrical
tocolysis NSAIDs can be given in the absence of alternative
therapy with beta-
adrenergic agents, and their risk can be minimized by ultrasonographic examination and monitoring of foetal cardiac function and diuresis. In the field of rheumatology,
corticosteroids would be a good alternative to
NSAIDs for
rheumatic diseases, but using
NSAIDs for
low back pain,
sciatica, haemorrhoids,
toothaches,
sinusitis, etc., would not be justified in pregnant women.
Self medication must be discouraged.