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- W2028851531 abstract "Prenatal ductal constriction or closure, consequent to maternal ingestion of cyclo-oxygenase inhibitors, has been described for indomethacin but only occasionally for nimesulide. We report a multicenter series of 8 cases of clinically significant ductal constriction following maternal ingestion of 1–2 oral doses of nimesulide leading to emergency operative delivery in 4. Considering the data in Table 1, we believe that two issues are to be underlined: 1) ductal musculature response to maternal nimesulide intake can be triggered also by a single oral dose of 100 mg (cases 2, 3, 5) and can be detected by ultrasound within 24 hours (cases 5, 7); 2) significant right heart dysfunction, need for emergency delivery and persistent neonatal pulmonary hypertension were all associated with: A) ductal peak velocity values of 2.8 m/s or higher; B) an intake-ultrasound interval of 3 days or more; C) intake of > 1 oral doses (cases 1, 4, 6); D) gestational age > 36 completed weeks. On the basis of these observations, it could be speculated that some fetuses may show hypersensitivity to nimesulide, that worsens the degree of the usually mild ductal constriction. This hypothesis seems to be supported by the fact that a single oral dose, usually devoid of clinically significant effects, is indeed sufficient to prompt the contraction of the ductal musculature in some cases (Table 1-cses 2, 3, 5). Along this lines, a higher nimesulide dose and time of exposure may have led to the development of clinically-relevant ductal constriction in hypersensitive fetuses (Table 1-cses 1, 4, 6). Although the real incidence of this adverse effect can not be deduced, we believe that patients and professionals should be alerted to the possibility that clinically-significant ductal constriction may follow maternal nimesulide self-medication, especially if taken near term." @default.
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- W2028851531 date "2004-08-01" @default.
- W2028851531 modified "2023-10-16" @default.
- W2028851531 title "P01.32: Haemodynamically significant ductal constriction in the 3rd trimester fetus following maternal self-medication with the COX-2 selective inhibitor nimesulide" @default.
- W2028851531 doi "https://doi.org/10.1002/uog.1338" @default.
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