Maternal Diclofenac Medication in Pregnancy Causing in Utero Closure of the Fetal Ductus Arteriosus and Hydrops
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This report describes a case of premature closure in utero of the ductus arteriosus (DA) diagnosed postnatally in a baby with hydrops and cardiac failure. An echocardiogram 6 h postnatally showed marked dilation of the right atrium and right ventricle with marked hypertrophy and impaired function, elevated pulmonary pressures, a small pericardial effusion, and no flow through the DA. The mother was unaware of her pregnancy until she presented in labor, and she had taken diclofenac medication in the preceding months. This case and the accompanying literature review illustrate the potential fetal and neonatal complications resulting from antenatal closure of the DA due to maternal diclofenac medication during pregnancy.
KeywordsDuctus arteriosus Premature closure Diclofenac Neonatal Hydrops
The authors thank Dr. Ian Sullivan, Consultant Cardiologist, for helpful comments on the case, Les Samuels, Advanced Practitioner Ultrasound, for reviewing the antenatal images and Sheila Wood, Principal Cardiology Technician, for providing the neonatal echocardiogram images.
Conflict of interest
Movie clip 1: Echocardiographic short-axis view showing RVH with a compressed “D”-shaped left ventricle. (MOV 820 kb)
Movie clip 2: Echocardiographic parasternal short-axis view showing the RV outflow tract on 2D imaging. (MOV 965 kb)