Ever use Celebrex or Indocin to stop PTL?

Specialties Ob/Gyn

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I was just reading about reaserch for this and was wondering how it was working out.Any feedback?

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Yes, we have used indocin for years in addition to terbutaline and magnesium therapy for preterm labor. Like so many things, it either works or it does not. Celebrex, we do NOT use for PTL, but for postpartum and post- surgical pain control for people who have either hemorrhage or have low platelets. Considered safer than toradol or motrin in these cases, as it is very enzyme-specific.

My place uses Indocin much like SmilingBlueEyes reported with mag and terb. We do not use Celebrex at all. Most of our indocin use is before and after rescue cerclage and in the preemies for PDA closure (althought that is not my field).

Specializes in Maternal - Child Health.
I was just reading about reaserch for this and was wondering how it was working out.Any feedback?

I had very resistant PTL with 2 of my pregnancies and used Indocin unsuccessfully both times. As I remember, there were 2 serious concerns regarding its use. First of all, it can (and did, in my case) severely reduce the production of amniotic fluid. That was why I had to stop it both times. With my second baby, the AFI was so significantly decreased that they kept me in the hospital on continuous fetal monitoring for several days until the volume increased, for fear of a cord accident.

There are also concerns regarding premature closure of the ductus arteriosus in the fetus if Indocin is given at certain points in gestation. Don't quote me, but I think it must be DC'd by about 30-32 weeks to avoid this complication.

Celebrex may be safer because of constriction of the ductus. Also Indocin may decrease amniotic fluid.

http://www.eurekalert.org/pub_releases/2002-09/wuso-cmb092302.php

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