Indomethacin can be used as a medical management for polyhydramnios. It is a prostaglandin synthetase inhibitor. The optimal dose of indomethacin is unknown. A 25mg oral dose can be given 6 hourly.
Fetal echocardiography should be started in the 24hr after the start of the indomethacin and then weekly. Discontinue the drug when there is severe constriction of ductus arteriosus or tricuspid regurgitation. Decrease the dose when there is lesser degree of constriction of ductus arteriosus. Amniotic fluid assessment should be done with USG once or twice weekly. Known side effects of drug are renal failure in neonates, premature ductus arteriosus, increased in perinatal mortality, necrotizing enterocolitis and intracranial haemorrhage.
Fetal echocardiography should be started in the 24hr after the start of the indomethacin and then weekly. Discontinue the drug when there is severe constriction of ductus arteriosus or tricuspid regurgitation. Decrease the dose when there is lesser degree of constriction of ductus arteriosus. Amniotic fluid assessment should be done with USG once or twice weekly. Known side effects of drug are renal failure in neonates, premature ductus arteriosus, increased in perinatal mortality, necrotizing enterocolitis and intracranial haemorrhage.
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