Hydrops Fetalis Caused by Maternal Indomethacin Treatment

Mogilner, B.M.; Ashkenazy, M.; Borenstein, Ρ; Lancet, M

doi:10.3109/00016348209156552

Cited by 30 publications

(5 citation statements)

References 14 publications

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“…Maternal side effects include the prolongation of pregnancy and labor [6,7]. Reported adverse fetal side effects of indomethacin and other NSAIDs include constricted ductus arteriosus (DA) [3,[8][9][10][11][12], limb ischemia [13], hydrops fetalis [14,15], oligohydramnios, ileal perforation [16], and cystic brain lesions [17]. The possible teratogenic effects of NSAIDs used in early pregnancy include gastroschisis, associated with aspirin and ibuprofen [3,11].…”

Section: Introductionmentioning

confidence: 99%

Effect of Diclofenac Sodium Administration during Pregnancy in the Postnatal Period

Gökçimen¹,

Aydin²,

Karaöz³

et al. 2001

Fetal Diagn Ther

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Objective: The present study aimed to investigate the possible postnatal effects on the liver, kidney and testicular tissues of the offspring of rats given diclofenac sodium (DS) during pregnancy. Methods: At the beginning of the experiment, 80 rats (20 males and 60 females) were raised together for mating purposes. At the end, 50 pregnant rats were obtained and used as the experimental subjects. All pregnant rats were divided into 2 groups, each with 25 rats. The rats of the control group received physiological serum, 1 cm³/kg live weight per day, and the rats of the treatment group were injected with DS, 1 mg/kg live weight per day from the 5th to the 20th day of pregnancy. Four weeks after birth, tissue samples were obtained under anesthesia by perfusion fixation from a total of 40 offspring, 20 (10 males, 10 females) from the control group and 20 (10 males 10 females) from the DS group. Paraffin sections were dyed with hematoxylin eosin and examined under light microscopy. Results: The gestation period was significantly prolonged with DS-treated rats (p < 0.001). A moderate significant enlargement in the periportal area (p < 0.05), sinusoidal dilatation (p < 0.001), bile duct proliferation (p < 0.001), pyknosis in the nucleus of hepatocytes, and vacuolar degeneration in parenchymal cells (p < 0.001) were observed in DS-treated rats. Morphological changes in the liver were found to be similar both in female and male rats. Under light microscopy a similar morphological structure was observed in the kidney and testicular tissues of both the DS-treated and control rats. Conclusion: Significant morphological changes were observed in the livers of the offspring whose parents had been treated with DS. No significant differences were observed in liver morphology between the female and male offspring. There were no significant effects of DS on the morphology of the kidney and testis in all offspring.

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Section: Introductionmentioning

confidence: 99%

Effect of Diclofenac Sodium Administration during Pregnancy in the Postnatal Period

Gökçimen¹,

Aydin²,

Karaöz³

et al. 2001

Fetal Diagn Ther

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“…Maternal administration of the prostaglandin synthe tase inhibitor indomethacin may lead to constriction of the fetal ductus arteriosus resulting in increased blood flow through the pulmonary bed, fetal pulmonary arterial hypertension, right ventricular overload, severe right heart changes, and congestive heart failure [5,[19][20][21][22], Constrictive effects of glucocorticoids on the ductus arter iosus have also been described [23], The prenatal diagno sis of indomethacin-induced constriction is based on increased ductal peak systolic and diastolic flow velocities of > 1.4 and >0.3 m/s, respectively [24], and a low pulsatility index (mean ± 2 SD: 1.25 ± 0.76) [10], There are only sporadic reports of idiopathic prema ture stenosis or closure of the ductus arteriosus. Pathologi cal examinations have demonstrated right atrial and ven tricular dilatation, definite signs of decompensated con gestive heart failure, and hydrops fetalis associated with idiopathic premature stenosis or closure of the ductus arteriosus with internal ductal diameters ranging from 0.0 to 2.0 mm [1][2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Idopathic Stenosis of the Ductus arteriosus Associated with Fetal Atrial Flutter

Mielke

Steil²,

Gonser³

1997

Fetal Diagn Ther

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Antenatal stenosis or closure of the ductus arteriosus unrelated to either congenital heart defects or prostaglandin inhibitors is considered to be uncommon, but may result in congestive heart failure, hydrops fetalis, and perinatal death. We report a case of idiopathic ductal stenosis detected prenatally by two-dimensional and Doppler echocardiography in a fetus presenting atrial flutter and right atrial dilatation at 31 weeks of gestation. Prenatal treatment with digoxin and verapamil resulted in conversion to sinus rhythm. The fetus was closely monitored. Congestive heart failure did not develop, and the fetus was delivered spontaneously in good condition at 39 weeks of gestation. In case of ductal stenosis, the potential risk of congestive heart failure must be considered, and maternal administration of drugs with constrictive effects on the ductus arteriosus, as indomethacin or betamethasone, should be avoided.

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“…Siu and Lee [23] reported severe pulmonary hypertension and temporary hypertrophic cardiomyopathy on the right side of the heart in newborn rats as a result of early closure of the DA following shortterm maternal exposure to DS. Some studies have reported that NSAIDs cause teratogenic side effects in the fetus, such as contraction of the DA, ischemia of the extremities, oligohydramnios, hydrops fetalis, cystic brain lesions, and ileal perforation [24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

The effects of different doses of diclofenac sodium on newborn rat hippocampus exposed during the third trimester

Elibol¹,

Kaplan²,

Altun³

et al. 2020

Turk J Vet Anim Sci

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The main aim of the present study was to examine the neurotoxic effects of prenatal exposure to varying doses of diclofenac sodium (DS) on the rat hippocampus. Twenty-eight Wistar albino adult female rats weighing 280-300 g were initially used for pregnancy. When vaginal plaques were seen in female rats, it was accepted as the 0th day of pregnancy. Female rats were divided into five main groups; pure control, saline, low dose DS (3.6 mg/kg), moderate dose DS (9 mg/kg), and high dose DS (18 mg/kg). They were exposed to these treatments during their gestation. After birth, all newborn male rats were euthanized by overdose anesthesia on the 7th postnatal day. Histological and stereological techniques were used for analyzing tissue samples. The stereological analyses in this study showed that the number of neurons in the hippocampus may be reduced due to the use of DS. Histological investigation of the drug-treated groups showed significant cell loss compared to the control. Darkly stained nuclei of the neurons in the high dose group compared to the other groups were also obvious. When the results are evaluated, it can be concluded that the use of diclofenac sodium during pregnancy may have teratogenic effects on the development of the nervous system.

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Hydrops Fetalis Caused by Maternal Indomethacin Treatment

Cited by 30 publications

References 14 publications

Effect of Diclofenac Sodium Administration during Pregnancy in the Postnatal Period

Effect of Diclofenac Sodium Administration during Pregnancy in the Postnatal Period

Prenatal Diagnosis of Idopathic Stenosis of the Ductus arteriosus Associated with Fetal Atrial Flutter

The effects of different doses of diclofenac sodium on newborn rat hippocampus exposed during the third trimester

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