초록 열기/닫기 버튼
임신 37주에 NSAIDs의 일종인 Nimesulide를 복용하고 조기 태아 동맥관 수축으로 인한 태아 심부전이 유발된 산모 1예를 보고 하고자 한다. 임신 38주 2일의 태아 초음파는 삼첨판 폐쇄부전, 폐동맥판 혈류 소실, 우측 심부전, 심장막 주위 삼출 및 양수 과소증을 보였다. 즉각적인 분만은 건강한 신생아와 심초음파 이상 소견의 극적인 호전을 가져왔다. 임신 후반기의 모체에서 NSAIDs에의 노출은 태아 동맥관의 조기수축과 심부전 그리고 태아 사망까지 유발할 수 있다. 따라서 임신 후반기의 NSAIDs 의 처방은 제한된 예에서 적절한 태아 심초음파 감시하에서 고려되어야겠다.
We report a case of premature constriction of the fetal ductus arteriosus following maternal ingestion of a cyclooxygenase-2 (COX-2) inhibitor at 37 weeks’ gestation. Fetal sonography at 38+2 weeks’ gestation revealed tricuspid regurgitation, absent transpulmonary valve flow, right heart enlargement, and pericardial effusion. An immediate delivery resulted in a good postnatal outcome with dramatic improvement in the clinical and echocardiographic findings. Maternal exposure to Non-steroidal anti-inflammatory drugs (NSAIDs), especially late in gestation, can cause premature constriction of the ductus arteriosus, heart failure, and fetal death. Therefore, the use of NSAIDs late in gestation should be considered in limited cases with close fetal heart monitoring.
We report a case of premature constriction of the fetal ductus arteriosus following maternal ingestion of a cyclooxygenase-2 (COX-2) inhibitor at 37 weeks’ gestation. Fetal sonography at 38+2 weeks’ gestation revealed tricuspid regurgitation, absent transpulmonary valve flow, right heart enlargement, and pericardial effusion. An immediate delivery resulted in a good postnatal outcome with dramatic improvement in the clinical and echocardiographic findings. Maternal exposure to Non-steroidal anti-inflammatory drugs (NSAIDs), especially late in gestation, can cause premature constriction of the ductus arteriosus, heart failure, and fetal death. Therefore, the use of NSAIDs late in gestation should be considered in limited cases with close fetal heart monitoring.
키워드열기/닫기 버튼
Ductus arteriosus, Non-steroidal anti-inflammatory drugs, Cyclooxygenase-2 inhibitor, Nimesulide
