title: Premature closure of the ductus arteriosus: variable response among monozygotic twins after in utero exposure to indomethacin.
abstract: Exposure of the fetus to indomethacin by administration of the drug to the mother may cause many side effects, including premature closure of the ductus arteriosus. Hypoxia is a predisposing factor for premature ductal closure and often occurs after maternal indomethacin therapy. We present two sets of monozygotic twins with twin-to-twin transfusion, where in utero ductal closure occurred in the donor twin while the recipient twin appeared unaffected. This selective closure of the ductus arteriosus suggests that the affected twin was predisposed to hypoxia and thus was more susceptible to ductal closure in response to indomethacin exposure.
authors.affiliation: Children's Healthcare of Atlanta at Egleston, Department of Pathology, Emory University, Atlanta, Georgia 30322, USA. bshehat@emory.edu
authors.forename: Bahig M
authors.initials: BM
authors.lastname: Shehata
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Bare
authors.forename: Tiffany D
authors.initials: TD
authors.lastname: Denton
authors.forename: Maria N
authors.initials: MN
authors.lastname: Habib
authors.forename: Jennifer O
authors.initials: JO
authors.lastname: Black
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000209:etiology / Q000473:pathology; D004373:Ductus Arteriosus / Q000187:drug effects* / Q000196:embryology* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D005330:Fetofetal Transfusion; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced / Q000150:complications / Q000235:genetics / Q000503:physiopathology; D007213:Indomethacin / Q000009:adverse effects* / Q000627:therapeutic use; D007231:Infant, Newborn; D006831:Polyhydramnios / Q000188:drug therapy; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D014430:Twins, Monozygotic / Q000187:drug effects* / Q000235:genetics
chemical_list: D015149:Tocolytic Agents; D007213:Indomethacin