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Korean Journal of Obstetrics & Gynecology 2008;51(7):771-776.
Published online July 1, 2008.
Fetal ductus arteriosus constriction and heart failure following maternal cyclooxygenase-2 inhibitor ingestion: A case report.
Min A Lee, Young Bok Ko, Yun Ee Rhee, Mee Young Chang, Hong Ryang Kil
1Department of Obstetrics and Gynecology, College of Medicine, Chungnam National University, Daejeon, Korea. rheyun@cnu.ac.kr
2Department of Pediatrics, College of Medicine, Chungnam National University, Daejeon, Korea.
We report a case of premature constriction of the fetal ductus arteriosus following maternal ingestion of a cyclooxygenase-2 (COX-2) inhibitor at 37 weeks' gestation. Fetal sonography at 38+2 weeks' gestation revealed tricuspid regurgitation, absent transpulmonary valve flow, right heart enlargement, and pericardial effusion. An immediate delivery resulted in a good postnatal outcome with dramatic improvement in the clinical and echocardiographic findings. Maternal exposure to Non-steroidal anti-inflammatory drugs (NSAIDs), especially late in gestation, can cause premature constriction of the ductus arteriosus, heart failure, and fetal death. Therefore, the use of NSAIDs late in gestation should be considered in limited cases with close fetal heart monitoring.
Key Words: Ductus arteriosus, Non-steroidal anti-inflammatory drugs, Cyclooxygenase-2 inhibitor, Nimesulide

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