Information from these cases was similar to what was found in the medical literature. Among the 35 cases reported to FDA through 2017, all were serious. We reviewed the medical literature and cases reported to FDA for data about low amniotic fluid levels or kidney problems in unborn babies associated with NSAID use during pregnancy. One exception to the above recommendations is the use of the low 81 mg dose of the NSAID aspirin for certain pregnancy-related conditions at any point in pregnancy under the direction of a health care professional. We will also update the Drug Facts labels of OTC NSAIDs intended for use in adults. The changes to the prescribing information also indicate that health care professionals should consider ultrasound monitoring of amniotic fluid if NSAID treatment extends beyond 48 hours and discontinue the NSAID if oligohydramnios is found. Use of NSAIDs if deemed necessary, between 20 and 30 weeks of pregnancy should be limited to the lowest effective dose for the shortest duration. At around 30 weeks, NSAIDs can cause a problem that may result in heart issues in the unborn baby. Growth restriction is classified as symmetric and asymmetric. We recommend avoiding NSAIDs in pregnant women at 20 weeks, rather than the 30 weeks currently described in NSAID prescribing information. Ultrasound biometry is the gold standard for assessment of fetal size and the amount of amniotic fluid. Low levels of amniotic fluid may indicate that the baby isnt producing enough urine, and that can mean there is an issue with the placenta. A modified biophysical profile is less involved but can be just as useful as a full BPP. Oligohydramnios is a medical condition in pregnancy characterized by a deficiency of amniotic fluid, the fluid that surrounds the fetus in the abdomen, in the amniotic sac. Amniotic fluid provides a protective cushion and helps the unborn babies’ lungs, digestive system, and muscles develop.įor prescription NSAIDS, we are requiring changes to the prescribing information to describe the risk of kidney problems in unborn babies that result in low amniotic fluid (oligohydramnios). It combines the nonstress test with an ultrasound to measure your amniotic fluid levels. After around 20 weeks of pregnancy, the unborn babies’ kidneys produce most of the amniotic fluid, so kidney problems can lead to low levels of this fluid. They include medicines such as aspirin, ibuprofen, naproxen, diclofenac, and celecoxib. NSAIDs are commonly used to relieve pain and reduce fevers. This can lead to low levels of amniotic fluid surrounding the baby and possible complications. On October 15, 2020, FDA warned that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) around 20 weeks or later in pregnancy may cause rare but serious kidney problems in an unborn baby. Praying that yours will too.Welcome to the FDA Drug Safety Podcast for health care professionals from the Division of Drug Information. Like I said, every story is different but mine had a happy ending. ) I did have to have a c-section because she didn't have enough room to move from a breech position, I never felt her kick because she couldn't, and she had a very fixable hip issue when she was born. I made it to 38 weeks! She is now a healthy and happy 3 year old with the most flexible hips you can imagine. They finally delivered my baby at 38 weeks when the fluid depleted altogether. I was monitored with lots of ultrasounds to make sure that my fluid levels never stayed critical for too long (my fluid levels changed by the day and even hour) and that the baby was still safe and sound. (Although I'm happy to do so if you think it would be helpful.) In a nutshell, I had fluid levels that oscillated between critically low and really low (3-6) from 21 weeks until 38 weeks when the baby was born. I shared my story earlier today on a post about oligohydramnios, so I don't want to bore you by repeating mundane details. Cells in the amniotic fluid can be tested for chromosomal. Testing may include a karyotype analysis, used to screen the babys chromosomes for abnormalities. The ultrasound for the first trimester screen looks for extra fluid behind the babys neck. Third, I went through something similar with my first but every story is different. Amniocentesis is a procedure in which a sample of amniotic fluid which contains fetal cells and various chemicals produced by the baby is removed from the uterus for testing. Second, Have they determined what is causing the low fluid? Is it a biological issue with your baby (like the baby not having functional kidneys) or with your placenta or what? That makes a huge difference. First, I'm sorry you're dealing with this.
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