Reversible oligohydramnios in the second trimester of pregnancy in two patients with long-term diclofenac exposure

- We describe 2 cases of oligohydramnios associated with long-term diclofenac exposure.
- The abnormalities occurred in the second trimester of pregnancy.
- In both cases oligohydramnios was reversible after discontinuation of diclofenac.

The use of non-steroidal anti-inflammatory drugs like diclofenac in the third trimester of pregnancy can cause severe side effects, in particular oligohydramnios, premature closure of ductus arteriosus, and fetal kidney damage. However, the treatment with non-steroidal anti-inflammatory drugs until gestational week 28 is accepted as relatively safe. Here we describe two retrospectively reported cases of early-onset oligohydramnios associated with long-term diclofenac exposure of at least 150 mg per day. The pathological findings were detected at gestational weeks 22 and 23, respectively. Amniotic fluid turned to normal after discontinuation of diclofenac in both cases, suggesting causality. Although early-onset oligohydramnios is a rare complication, caution for long-term diclofenac use in high doses is recommended even before gestational week 28.