Respondek M, Weil S R, Huhta J C
Department of Sonography, Polish Mother's Memorial Hospital, Lodz.
Ultrasound Obstet Gynecol. 1995 Feb;5(2):86-9. doi: 10.1046/j.1469-0705.1995.05020086.x.
Fetal echocardiograms were evaluated in 315 studies performed in 107 fetuses exposed to indomethacin. In the majority of cases, the results of the fetal echocardiography study were within normal limits (74%). The most common abnormal phenomena were tricuspid valve regurgitation (10%), ductal constriction (6%), tricuspid valve regurgitation and ductal constriction (5%), an increased ductal velocity (2%), and other (3%). The difference between the prevalence of ductal constriction in the whole series of studies (11%) compared to the prevalence of ductal constriction per fetus (25%) (p < 0.001) suggests that this phenomenon was only temporary and disappeared when medication was discontinued. The mean gestational age for detection of tricuspid valve regurgitation was 27.7 +/- 2.8 weeks and for ductal constriction, 30.9 +/- 2.1 weeks (t-test, p < 0.01). Trivial tricuspid valve regurgitation was detected at a mean of 26.7 +/- 2.2 weeks and significant tricuspid valve regurgitation at 29.6 +/- 2.3 weeks (t-test, p < 0.01). We conclude that indomethacin treatment is relatively safe for the fetal heart. The most common side-effects are tricuspid valve regurgitation and ductal constriction. Tricuspid valve regurgitation may be detected before ductal constriction, but by itself it is not a contraindication for the continued use of indomethacin.
对107例暴露于吲哚美辛的胎儿进行的315项研究中的胎儿超声心动图进行了评估。在大多数情况下，胎儿超声心动图研究结果在正常范围内（74%）。最常见的异常现象是三尖瓣反流（10%）、动脉导管狭窄（6%）、三尖瓣反流合并动脉导管狭窄（5%）、动脉导管流速增加（2%）以及其他（3%）。整个研究系列中动脉导管狭窄的发生率（11%）与每个胎儿动脉导管狭窄的发生率（25%）之间的差异（p<0.001）表明，这种现象只是暂时的，停药后会消失。检测到三尖瓣反流的平均孕周为27.7±2.8周，检测到动脉导管狭窄的平均孕周为30.9±2.1周（t检验，p<0.01）。轻度三尖瓣反流的平均检测孕周为26.7±2.2周，重度三尖瓣反流的平均检测孕周为29.6±2.3周（t检验，p<0.01）。我们得出结论，吲哚美辛治疗对胎儿心脏相对安全。最常见的副作用是三尖瓣反流和动脉导管狭窄。三尖瓣反流可能在动脉导管狭窄之前被检测到，但它本身并不是继续使用吲哚美辛的禁忌症。
