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孕晚期孕妇服用双氯芬酸后动脉导管的产前狭窄。

Prenatal constriction of the ductus arteriosus following maternal diclofenac medication in the third trimester.

作者信息

Aker Karoline, Brantberg Anne, Nyrnes Siri Ann

机构信息

Department of Pediatrics, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.

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.

出版信息

BMJ Case Rep. 2015 Oct 1;2015:bcr2015210473. doi: 10.1136/bcr-2015-210473.

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.

摘要

我们描述了一例21岁初产妇,孕36周,因腹痛入住当地医院。在2天内她总共服用了6剂50毫克的双氯芬酸。一天后,胎心监护仪难以记录到胎儿心跳。超声检查显示胎儿有腹水,三尖瓣处有异常血流。该患者被转诊至三级胎儿医学中心。胎儿超声心动图显示,除腹水和三尖瓣反流外,动脉导管狭窄、右心室扩张以及肺动脉血流减少。立即剖宫产取得了良好的新生儿结局。

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本文引用的文献

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Cyclo-oxygenase (COX) inhibitors for treating preterm labour.用于治疗早产的环氧化酶(COX)抑制剂。
Cochrane Database Syst Rev. 2015 Jun 5;2015(6):CD001992. doi: 10.1002/14651858.CD001992.pub3.
3
Diclofenac-induced intrauterine ductal closure.双氯芬酸导致的子宫内导管闭合。
Fetal Diagn Ther. 2013;34(2):133-4. doi: 10.1159/000350979. Epub 2013 Jun 5.
4
Nonsteroidal anti-inflammatory drugs during pregnancy and the initiation of lactation.孕期和哺乳期使用非甾体抗炎药。
Anesth Analg. 2013 May;116(5):1063-1075. doi: 10.1213/ANE.0b013e31828a4b54. Epub 2013 Apr 4.
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Maternal ingestion of diclofenac leading to renal failure in newborns.母亲服用双氯芬酸导致新生儿肾衰竭。
Pediatr Nephrol. 2012 Jun;27(6):1033-6. doi: 10.1007/s00467-012-2114-z. Epub 2012 Feb 14.

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