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Safety of Ibuprofen tocolysis.
MedLine Citation:
PMID:  24770033     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Prostaglandins play a key role in uterine contractions. Term and preterm myometrium has increased expression of prostaglandin receptors. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the cyclooxygenase receptor and thereby decrease uterine contractions during preterm labor. The NSAID indomethacin has been most extensively studied. Its use has been associated with oligohydramnios and premature closure of the fetal ductus arteriosus. Published data on the NSAID ibuprofen as a tocolytic are sparse. Our study examines fetal effects of ibuprofen when used as a tocolyitc.
METHODS: A retrospective observational study was conducted on patients placed on ibuprofen for tocolysis before 32 weeks of gestation from January 2011 to September 2013. Inclusion criteria were preterm labor before 32 weeks of gestation, decreased cervical length, and cerclage. Exclusion criteria were preeclampsia and congenital anomalies. Evidence of oligohydramnios and premature ductus closure was gathered from ultrasound reports. Possible impending premature ductal closure was evidenced by tricuspid regurgitation, increased ductus arteriosus peak velocity (150 cm/second upper limit of normal), and decreased pulsatility index (two lower limits of normal).
RESULTS: A total of 84 fetuses were analyzed for oligohydramnios, and 94 fetuses were analyzed for tricuspid regurgitation, elevated ductus arteriosus peak velocity, and decreased pulsatility index. Preliminary results show that 8.3% developed oligohydramnios, 1.1% developed tricuspid regurgitation, 9.6% developed increased ductus arteriosus peak velocity, and 22.3% developed decreased pulsatility index.
CONCLUSIONS: This unique study demonstrates that ibuprofen has minimal effects on amniotic fluid level or fetal cardiac function. These data can be used to establish criteria for ibuprofen tocolysis.
Authors:
Jessica R Jackson; James Thorp; Julie Decesare; Lisa Mook Sang; Elizabeth Hernandez-Marin; Bonnie Gillis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  123 Suppl 1     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  149S-50S     Citation Subset:  AIM; IM    
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