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Am J Perinatol 1999; Volume 16(Number 9): 0441-0444
DOI: 10.1055/s-1999-6810
Copyright © 1999 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212)760-0888 x132

Perinatal Vasoconstrictive Renal Insufficiency Associated With Maternal Nimesulide Use

Daniel Landau, Ilan Shelef, Hanna Polacheck, Kyla Marks, Gershon Holcberg
  • Departments of Pediatrics (DL), Radiology (IS), Pharmacy (HP), Neonatology (KM), and Obstetrics (GH), Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel
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Publication Date:
31 December 1999 (online)

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ABSTRACT

-A full-term newborn developed oliguric renal failure at 24 hr of life, which persisted for several days. Her mother ingested therapeutic doses of nimesulide, a nonsteroidal anti-inflammatory (cyclo-oxygenase-2 inhibitor) drug, during the last 2 weeks of pregnancy. She was found at delivery to have developed oligohydramnion, esophagitis, and a bleeding peptic ulcer. The infant's fractional excretion of sodium was very low (0.5%) pointing for a severe vasoconstrictive mechanism involved. Renal sonogram showed hyperechogenic medullary papillae, which resolved during convalescence. This case emphasizes the importance of renal prostagandins in the control of vascular tone and sodium homeostasis. This is the first report of an adverse effect of fetal renal circulation by maternal ingestion of nimesulide.

KEYWORD

Renal failure, acute - nimesulide - nonsteroidal anti-inflammatory drugs