What is the impact on foetus in case of Indomethacin used in third trimester?
High-Yield Explanation
Ref: Goodman & Gillman 13th ed. P 690 - 697* Indomethacin is a potent nonselective inhibitor of COX enzyme. It is considered 20 times more potent than aspirin* Other actions are:# Inhibit motility of neutrophils# Depress biosynthesis of mucopolysacchharides# COX independent vasoconstrictor effect# Anti-inflammatory, antipyretic and analgesic action* An IV formulation of indomethacin is approved for closure of persistent patent ductus arteriosus in premature infants.* The regimen involves intravenous administration of 0.1-0.25mg/kg every 12 hours for three doses, with the course repeated one time if necessary.* Successful closure can be expected in more than 70% of neonates treated.* An injectable formulation of ibuprofen is an alternative for the treatment of patent ductus arteriosus.* The agent can also cause stenosis of ductus arteriosus and oligohydramnios particularly in foetuses older than 32 weeks of gestation.