PERSISTENT PULMONARY HYPERTENSION AFTER MATERNAL NAPROXEN INGESTION IN A TERM NEWBORN: A CASE REPORT

Ajay J. Talati; Mubadda A. Salim; Sheldon B. Korones

doi:10.1055/s-2000-9271

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2000; Volume 17(Number 02): 069-072
DOI: 10.1055/s-2000-9271

PERSISTENT PULMONARY HYPERTENSION AFTER MATERNAL NAPROXEN INGESTION IN A TERM NEWBORN: A CASE REPORT

Ajay J. Talati^1,2 , Mubadda A. Salim¹ , Sheldon B. Korones^1,2

¹Department of Pediatrics, The University of Tennessee, Memphis, Memphis, Tennessee
²Department of Obstetrics & Gynecology, The University of Tennessee, Memphis, Memphis, Tennessee

Abstract

ABSTRACT

Constricting effect of indomethacin on the ductus arteriosus of the fetus is well known. The fetal effects of other nonsteroid anti-inflammatory drugs (NSAIDs) like naproxen are not well reported. We report here a case of a 3790-g term neonate who developed persistent pulmonary hypertension after birth with a closed ductus arteriosus. The mother admitted to taking naproxen sodium immediately prior to the birth of the infant. The course of illness was progressively better on conservative management. Like indomethacin, other NSAIDs can also cause premature closure of fetal ductus arteriosus, pulmonary hypertension, and life-threatening problems to the neonate. Patient education regarding over-the-counter pain medication during pregnancy should be emphasized.

KEYWORD

NSAID - ductus arteriosus - prenatal

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Referenzen

REFERENCES

1 Schoenfeld A, Bar Y, Merlob P, Ovadia Y. NSAIDs: maternal and fetal considerations. Am J Reprod Immunol . 1992; 28 141-147
2 Moise K J. Effect of advancing gestational age on the frequency of fetal ductal constriction in association with maternal indomethacin use. Am J Obstet Gynecol . 1993; 168 1350-1353
3 Kleinman C S. Abnormal fetal cardiovascular physiology. In: Polin RA and Fox WW, eds. Fetal and Neonatal Physiology, Vol 1. Philadelphia: WB Saunders Company 1992: 666-670
4 Wild L M, Nickerson P A, Morin III C F. Ligating the ductus arteriosus before birth remodels the pulmonary vasculature of the lamb. Pediatr Res . 1989; 25 251-257
5 Morin III C F. Ligating the ductus arteriosus before birth causes persistent pulmonary hypertension in the newborn lamb. Pediatr Res . 1989; 25 245-250
6 Murphy J D, Rabinovitch M, Goldstein J D, Reid L M. The structural basis of persistent pulmonary hypertension. J Pediatr . 1981; 98 962-967
7 Van den Veyver B I, Moise K J, Ou C N, Carpenter R J. The effect of gestational age and fetal indomethacin levels on the incidence of fetal ductus arteriosus. Obstet Gynecol . 1993; 82 500-504
8 Takahashi Y, Harada K, Ishida A, Tanaka T, Tsuda A, Takada G. Doppler echocardiographic findings of indomethacin-induced occlusion of the fetal ductus arteriosus. Am J Perinatol . 1996; 13 15-18
9 Saenger J S, Mayer C, D'angelo L J, Manci E A. Ductus-dependent fetal cardiac defects contraindicate indomethacin tocolysis. J Perinatol . 1992; XII 41-47
10 Moise K J, Huhta J C, Sharif D S. Indomethacin in the treatment of premature labor. Effects on fetal ductus arteriosus. N Engl J Med . 1988; 319 327-331
11 Levin D L, Fixler D E, Morriss F C, Tyson J. Morphologic analysis of the pulmonary vascular bed in infants exposed in utero to prostaglandin synthetase inhibitors. J Pediatr . 1978; 92 478-483
12 Momma K, Takeuchi H. Constriction of fetal ductus arteriosus by non-steroidal anti-inflammatory drugs. Prostaglandins . 1983; 26 631-6431