title: Maternal diclofenac medication in pregnancy causing in utero closure of the fetal ductus arteriosus and hydrops.
abstract: This report describes a case of premature closure in utero of the ductus arteriosus (DA) diagnosed postnatally in a baby with hydrops and cardiac failure. An echocardiogram 6 h postnatally showed marked dilation of the right atrium and right ventricle with marked hypertrophy and impaired function, elevated pulmonary pressures, a small pericardial effusion, and no flow through the DA. The mother was unaware of her pregnancy until she presented in labor, and she had taken diclofenac medication in the preceding months. This case and the accompanying literature review illustrate the potential fetal and neonatal complications resulting from antenatal closure of the DA due to maternal diclofenac medication during pregnancy.
authors.affiliation: Neonatal Intensive Care Unit, Norfolk & Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK.
authors.forename: Aravind T
authors.initials: AT
authors.lastname: Shastri
authors.forename: Dalia
authors.initials: D
authors.lastname: Abdulkarim
authors.forename: Paul
authors.initials: P
authors.lastname: Clarke
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D004008:Diclofenac / Q000009:adverse effects*; D004373:Ductus Arteriosus / Q000187:drug effects* / Q000196:embryology; D015150:Echocardiography, Doppler; D005260:Female; D005318:Fetal Heart / Q000187:drug effects*; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D016216:Ultrasonography, Prenatal
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac