title: Prenatal constriction of the ductus arteriosus following maternal diclofenac medication in the third trimester.
abstract: We describe a case of a 21-year-old primigravida at 36 weeks' gestation who was admitted to a local hospital because of abdominal pain. She was prescribed a total of six doses of diclofenac 50 mg over 2 days. One day later, there was difficulty registering the fetal heartbeats on cardiotocography. Ultrasound examination revealed a fetus with ascites and pathological flow over the tricuspid valve. The patient was referred to a tertiary centre for fetal medicine. Fetal echocardiography revealed, in addition to ascites and tricuspid regurgitation, a constricted ductus arteriosus, dilated right ventricle and reduced flow in the pulmonary artery. Immediate caesarean section resulted in an excellent neonatal outcome.
authors.affiliation: Department of Pediatrics, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Karoline
authors.initials: K
authors.lastname: Aker
authors.affiliation: Department of Gynecology and Obstetrics, National Center for Fetal Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Anne
authors.initials: A
authors.lastname: Brantberg
authors.affiliation: Department of Pediatrics, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Siri Ann
authors.initials: SA
authors.lastname: Nyrnes
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000188:drug therapy*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001201:Ascites / Q000000981:diagnostic imaging / Q000473:pathology; D015148:Cardiotocography; D002585:Cesarean Section; D003251:Constriction, Pathologic / Q000139:chemically induced / Q000473:pathology; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D004374:Ductus Arteriosus, Patent / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D004452:Echocardiography / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy*; D011263:Pregnancy Trimester, Third; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology; D016216:Ultrasonography, Prenatal / Q000379:methods
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac