Can a cyclo-oxygenase type-2 selective tocolytic agent avoid the fetal side effects of indomethacin?
We evaluated the efficacy and safety of nimesulide (100 mg orally twice daily for > 48 hours) in a pilot series of five women (two with twin pregnancies) at 24(+6) weeks (range 21(+3) - 27(+2)) in preterm labour which was unresponsive to intravenous ritodrine. Nimesulide therapy was continued for eight days (5-16) and was associated with a prolongation of pregnancy of 27 days (6-69). Oligohydramnios occurred in all seven fetuses after three to nine days of therapy, and in the five pregnancies that continued after discontinuation of nimesulide, it resolved within four days (2-7). None of the babies manifested permanent renal damage.
Locatelli
A
A
Department of Obstetrics and Gynaecology, San Gerardo's Institute of Biomedical Sciences, University of Milano-Bicocca, Monza, Italy.
Vergani
P
P
Bellini
P
P
Strobelt
N
N
Ghidini
A
A
D000284:Administration, Oral; D000328:Adult; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D008565:Membrane Proteins; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D016104:Oligohydramnios / Q000139:chemically induced*; D010865:Pilot Projects; D011247:Pregnancy; D011451:Prostaglandin-Endoperoxide Synthases; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects*; D015149:Tocolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D013449:Sulfonamides; D015149:Tocolytic Agents; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; C012655:nimesulide; D007213:Indomethacin