Acute severe reversible oligohydramnios induced by indomethacin in a patient with rheumatoid arthritis: a case report and review of the literature.

Although the association between oligohydramnios and indomethacin use for premature labor has been well known for many years, there have been few cases published about it. We present a case of indomethacin-induced oligohydramnios due to use in a patient for rheumatoid arthritis. A 27-year-old G2P1 woman was referred to our prenatal unit with oligohydramnios at 33 weeks of pregnancy. Ultrasonography revealed severe oligohydramnios with an amniotic fluid index of 0.9 cm. She gave a history of daily 150 mg indomethacin use for newly diagnosed rheumatoid arthritis. All possible reasons for oligohydramnios were excluded and indomethacin was discontinued. In four days the amniotic fluid was observed as normal. We concluded that the oligohydramnios caused by indomethacin occurs quickly, is dose-related and reversible. Amniotic fluid volume should be monitored while using indomethacin.