title: Reversible oligohydramnios in the second trimester of pregnancy in two patients with long-term diclofenac exposure.
abstract: The use of non-steroidal anti-inflammatory drugs like diclofenac in the third trimester of pregnancy can cause severe side effects, in particular oligohydramnios, premature closure of ductus arteriosus, and fetal kidney damage. However, the treatment with non-steroidal anti-inflammatory drugs until gestational week 28 is accepted as relatively safe. Here we describe two retrospectively reported cases of early-onset oligohydramnios associated with long-term diclofenac exposure of at least 150mg per day. The pathological findings were detected at gestational weeks 22 and 23, respectively. Amniotic fluid turned to normal after discontinuation of diclofenac in both cases, suggesting causality. Although early-onset oligohydramnios is a rare complication, caution for long-term diclofenac use in high doses is recommended even before gestational week 28.
authors: Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy, Charité-Universitätsmedizin Berlin, Germany. Electronic address: stephan.scherneck@charite.de.
authors: Stephan
authors: S
authors: Scherneck
authors: Department of Obstetrics and Gynecology, University of Rostock, Rostock, Germany.
authors: Franziska Lilli
authors: FL
authors: Schöpa
authors: Obstetrics and Gynecology, Center for Prenatal Diagnosis Kudamm-199, Berlin, Germany.
authors: Michael
authors: M
authors: Entezami
authors: Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy, Charité-Universitätsmedizin Berlin, Germany.
authors: Angela
authors: A
authors: Kayser
authors: Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy, Charité-Universitätsmedizin Berlin, Germany.
authors: Corinna
authors: C
authors: Weber-Schoendorfer
authors: Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy, Charité-Universitätsmedizin Berlin, Germany.
authors: Christof
authors: C
authors: Schaefer
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D057915:Drug Substitution; D005260:Female; D005865:Gestational Age; D006801:Humans; D050498:Live Birth; D016104:Oligohydramnios / Q000139:chemically induced* / Q000175:diagnosis; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D059285:Pregnancy, Twin; D012307:Risk Factors; D012585:Sciatica / Q000175:diagnosis / Q000188:drug therapy*; D014147:Tramadol / Q000008:administration & dosage; D016216:Ultrasonography, Prenatal
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D014147:Tramadol
keywords: Adverse drug effects; Diclofenac; NSAID; Oligohydramnios; Pregnancy