Prescribing Indomethacin in Pregancy to treat polyhydramnios/ to prevent Preterm labour ?? Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed in pregnancy to treat fever, pain and inflammation. We know that . Such drugs are also used for chronic use of these agents during pregnancy are inflammatory bowel or chronic rheumatic diseases. Since the seventies, NSAIDs have been used as effective tocolytic agents: indomethacin has been the reference drug, delaying delivery for at least 48 hours and up to 7-10 days. Additionally, self-medication with NSAIDs is practiced by pregnant women.
NSAIDs given to pregnant women
cross the placenta and may cause embryo-fetal and neonatal adverse effects,
depending on the type of agent, the dose and duration of therapy, the period of
gestation, and the time elapsed between maternal NSAID administration and
delivery. These effects derive from the action mechanisms of NSAIDs (mainly
inhibition of prostanoid activity) and from the physiological changes in drug
pharmacokinetics occurring during pregnancy. Increased risks of miscarriage and
malformations are associated with NSAID use in early pregnancy. Conversely,
exposure to NSAIDs after
30 weeks' gestation is associated with an increased risk of premature closure
of the fetal ductus arteriosus and oligohydramnios. Fetal and neonatal
adverse effects affecting the brain, kidney, lung, skeleton, gastrointestinal
tract and cardiovascular system have also been reported after prenatal exposure
to NSAIDs.
NSAIDs should be given in
pregnancy only if the maternal benefits outweigh the potential fetal risks, at
the lowest effective dose and for the shortest duration possible.
No comments:
Post a Comment