Lange I R, Harman C R, Ash K M, Manning F A, Menticoglou S
Department of Obstetrics and Gynaecology, University of Manitoba, Winnipeg, Canada.
Am J Obstet Gynecol. 1989 Mar;160(3):552-7. doi: 10.1016/s0002-9378(89)80024-9.
Six twin pregnancies complicated by hydramnios and premature labor were prospectively studied to determine whether indomethacin reduces amniotic fluid. Requirements for study entry included a gestational age less than 32 completed weeks and an amniotic fluid greater than 10 cm in one or both sacs. The amniotic fluid was measured using real-time ultrasonography before, during, and after treatment. Indomethacin treatment was initiated as a 100 mg rectal suppository and maintained thereafter by 50 mg orally every 6 hours. Treatment was discontinued after 32 completed weeks' gestation, if the patient was asymptomatic and the amniotic fluid was "normal" (less than 8 cm) or after the onset of oligohydramnios in one or both sacs (less than 2 cm). The interval from initiation of treatment to delivery ranged from 12 to 101 days. A coincidental reduction in amniotic fluid was observed in all seven treatment cycles. The time interval to obtain "normal" fluid ranged from 4 to 20 days (mean, 12.5 days). There were no perinatal complications attributable to indomethacin treatment. These data suggest that in selected pregnancies complicated by hydramnios, indomethacin may be of value not only in prolonging gestation but also in amniotic fluid reduction.
对6例并发羊水过多和早产的双胎妊娠进行前瞻性研究，以确定吲哚美辛是否能减少羊水。研究入选标准包括妊娠周数小于32足周，且一个或两个羊膜囊内羊水深度大于10厘米。在治疗前、治疗期间和治疗后，使用实时超声测量羊水。吲哚美辛治疗起始剂量为100毫克直肠栓剂，此后每6小时口服50毫克维持。妊娠32足周后，如果患者无症状且羊水“正常”（小于8厘米），或一个或两个羊膜囊出现羊水过少（小于2厘米），则停止治疗。从开始治疗到分娩的间隔时间为12至101天。在所有7个治疗周期中均观察到羊水同时减少。达到“正常”羊水量的时间间隔为4至20天（平均12.5天）。没有可归因于吲哚美辛治疗的围产期并发症。这些数据表明，在选定的并发羊水过多的妊娠中，吲哚美辛不仅在延长妊娠期方面可能有价值，而且在减少羊水量方面也可能有价值。
