Healthcare
No matter how we manage our health, efficacy, risks and costing are top concernsAntenatal indomethacin should be used carefully in tocolysis because necrotizing enterocolitis risk
Antenatal indomethacin is a medication which also given to suppress premature labor.
Despite little evidence showed on this non-steroidal anti-inflammatory drug (NSAID) in improving neonatal outcomes, the drug continues to be used so far.
However, because postnatal indomethacin has been associated with necrotizing enterocolitis in preemies and it readily crosses the placenta, the researchers investigated the potential risk when used for tocolysis.
Reported in Pediatrics on July issue, the study authors, Dr Beena G. Sood together with Children’s Hospital of Michigan in Detroit, and colleagues said that the use of indopmethacin should be used carefully because it significantly developed necrotizing enterocolitis in preemies.
Based on their findings after reviewed the records of 628 infants born between 23 and 32 weeks of gestational age, there were 28 infants developed necrotizing enterocolitis in the 15 days after delivery. In the group as a whole, 63 infants had received antenatal indomethacin within 15 days before delivery.
Overall, the authors concluded that indomethacin tocolysis should be considered whether the benefits outweigh the risks.
However, when it used, “patients should be educated regarding fetal risks and benefits and the neonatalogist informed of fetal exposure to indomethacin at delivery”, although this findings should also confirmed with larger cohort study and randomized trial.
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