NEONATAL LIMB ISCHEMIA FOLLOWING MATERNAL INDOMETHACIN TREATMENT IN TWIN PREGNANCIES

The prenatal administration of indomethacin in obstetric management ha s been implicated as a cause of neonatal cardio-pulmonary, gastrointes tinal and renal complications. The present report describes two cases of twin pregnancy resulting in premature delivery at the 33rd and 30th week following prolonged maternal indomethacin treatment for 9 and 4 weeks respectively. Neonatal cardiovascular and renal complications we re observed and an unusual severe ischemia of a lower limb occured in each of the first twins following insertion of an umbilical arterial l ine. It is suggested that prolonged ante natal exposure to the drug ma y increase the systemic arterial constrictive reactivity in some newbo rn infants and that special caution should be exercised during arteria l catheterization of susceptible cases.