Document Detail


Isolated small bowel perforation following intrauterine treatment with indomethacin.
MedLine Citation:
PMID:  7945625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Indomethacin, a prostaglandin synthetase inhibitor, is an effective tocolytic agent that may have adverse fetal side effects such as constriction of the ductus arteriosus, pulmonary hypertension, and reduced urine production. We describe an unusual neonatal complication following 6 days of tocolysis with indomethacin. A 22-year-old gravida 5, para 3104 was admitted at 25 weeks of gestation in labor. Attempts to stop labor using magnesium sulfate and terbutaline failed. The contractions stopped following the administration of indomethacin, which was continued for 6 days. On day 7, due to contractions and vaginal bleeding, she underwent a classic cesarean section. The female newborn, weighting 1044 g, did well for 2 days, when she developed pneumoperitoneum. On laparotomy, an isolated midileal perforation was found, with otherwise normal-appearing bowel. Isolated intestinal perforation has been described in premature neonates who were treated with indomethacin for patent ductus arteriosus. This complication is caused by splanchnic ischemia secondary to the loss of the vasodilatory effect of prostaglandins. This case indicates that this rare but serious complication may also follow intrauterine exposure to indomethacin.
Authors:
M D Fejgin; M L Delpino; K S Bidiwala
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of perinatology     Volume:  11     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  1994 Jul 
Date Detail:
Created Date:  1994-12-02     Completed Date:  1994-12-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  295-6     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Michael Reese Medical Center, Chicago, Illinois.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fetal Diseases / chemically induced*
Humans
Ileal Diseases / chemically induced*
Indomethacin / adverse effects*,  therapeutic use
Infant, Newborn
Intestinal Perforation / chemically induced*
Pregnancy
Tocolysis*
Chemical
Reg. No./Substance:
53-86-1/Indomethacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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