Indomethacin therapy in the treatment of symptomatic polyhydramnios
Article Abstract:
The factors that regulate the volume of amniotic fluid (the fluid in which the fetus floats) are not well understood, but it seems that fetal urination and swallowing are important regulators. Indomethacin, a drug with anti-inflammatory, analgesic, and anti-pyretic (fever-reducing) properties, appears to induce oligohydramnios, a condition of too little amniotic fluid, possibly because it reduces fetal urine output. Therefore, the drug has been used to treat polyhydramnios (too much amniotic fluid). To determine the effects of indomethacin on amniotic fluid volume, fetal urine volume in eight pregnant women was estimated by ultrasound techniques, and fluid volume was estimated by amniocentesis. Amniocentesis was performed routinely to withdraw fluid to alleviate patients' symptoms (decompression). Results showed that fetal urine output declined during treatment, as did the volume of amniotic fluid. Prior to drug treatment, the average fluid volume was 2,355 milliliters, which dropped to 1,608 milliliters during treatment. Only one patient required further amniocentesis for decompression. Three pregnancies were twins: of the 11 infants born, three were stillborn and one died three months later. Overall, indomethacin after amniotic fluid decompression seemed effective in managing polyhydramnios. The method offers an alternative to repeated decompressions. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
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The use of nimodipine in a patient with eclampsia: color flow Doppler demonstration of retinal artery relaxation
Article Abstract:
Nimodipine may be effective in treating eclamptic patients with severe vasospasm. Color flow Doppler ultrasonography was used to monitor the decrease in the retinal artery pulsatility index in an eclamptic patient treated with nimodipine. Eclampsia is a severe complication of pregnancy characterized by convulsions, coma and extremely high blood pressure. An unconscious 18-year-old woman 37 weeks pregnant was admitted to a hospital emergency department. Initial therapy consisted of a 10 milligram intravenous dose of diazepam and six grams of magnesium sulphate administered over 15 minutes. The patient had two more seizures. A computed tomographic scan of the brain revealed a generalized vasospasm with no bleeding. A cesarean section was performed. Nimodipine was administered at a rate of 30 milligrams every four hours to reduce the vasospasm. The pulsatility index of the central retinal artery was monitored during nimodipine administration. In 40 minutes the baseline value of 1.04 was reduced to .53. The patient improved rapidly.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1993
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