Effect of advancing gestational age on the frequency of fetal ductal constriction in association with maternal indomethacin use.
OBJECTIVE
The objective of this study was to determine whether indomethacin is associated with an increased incidence of constriction of the human fetal ductus arteriosus with advancing gestational age.


METHODS
A retrospective analysis of fetal echocardiograms performed in 44 patients with premature labor or hydramnios treated with indomethacin (25 mg orally every 6 hours) was undertaken. Fisher's exact test, Kaplan-Meier survival analysis, and log-rank techniques were used; a value of p < 0.05 was considered statistically significant.


RESULTS
The frequency of ductal constriction was similar for fetuses of singleton and multiple gestations. A dramatic increase in constriction was noted at 32 weeks' gestation when the rate of compromise approached 50%.


CONCLUSIONS
The use of indomethacin should be restricted to gestational ages of < 32 weeks. In multiple gestations each fetus should be evaluated by echocardiography, because the ductal response may vary between individual fetuses.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX.
K J
KJ
Moise
D003251:Constriction, Pathologic / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology; D004373:Ductus Arteriosus; D004452:Echocardiography; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005865:Gestational Age; D006331:Heart Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007213:Indomethacin / Q000009:adverse effects*; D011247:Pregnancy; D012189:Retrospective Studies; D014310:Triplets; D014427:Twins; D016216:Ultrasonography, Prenatal
D007213:Indomethacin