Fetal ductus arteriosus constriction following maternal analgesic exposure


Çaklr A., Kahraman E., Gedik D., Akgün N. B., Yüksel M. A.

Case Reports in Perinatal Medicine, cilt.15, sa.1, 2026 (ESCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1515/crpm-2026-0002
  • Dergi Adı: Case Reports in Perinatal Medicine
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Anahtar Kelimeler: ductus arteriosus constriction, fetal echocardiography, indomethacin, paracetamol, pregnancy
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Objectives: Premature constriction of the fetal ductus arteriosus is a clinically relevant cause of fetal cardiac compromise. Maternal exposure to prostaglandin-inhibiting analgesics is a recognized trigger. We describe two pregnancies complicated by fetal ductus arteriosus constriction temporally associated with maternal analgesic use. Case presentation: In the first case, ductal constriction occurred after a seven-day course of indomethacin initiated at 28 weeks' gestation for polyhydramnios. Although initial improvement followed drug discontinuation, recurrent constriction with right ventricular dilation, severe tricuspid regurgitation, ductus venosus A-wave reversal, and a non-reactive fetal heart rate tracing indicated progressive hemodynamic compromise, prompting preterm delivery at 31+6 weeks. Postnatal echocardiography showed normalization of right ventricular function. In the second case, ductal constriction with right ventricular dilation and tricuspid regurgitation was detected at 38+5 weeks after frequent third-Trimester use of a paracetamol-containing analgesic. Delivery at 39 weeks was performed primarily for prior uterine surgery, and postnatal evaluation confirmed normal pulmonary pressures and right ventricular function. Conclusions: Maternal exposure to prostaglandin-inhibiting analgesics should be considered in cases of fetal ductus arteriosus constriction. Careful medication history and targeted fetal echocardiography are essential for timely diagnosis and appropriate perinatal management.