A preterm infant born at 29 weeks with a haemodynamically significant patent ductus arteriosus is planned for indomethacin closure. Which of the following findings is a CONTRAINDICATION to giving indomethacin?

• A Serum creatinine of 2.1 mg/dL ✓
• B Platelet count of 110,000 per microlitre
• C Echocardiographic ductal diameter of 3 mm
• D Gestational age of 29 weeks

Explanation

Indomethacin reduces renal prostaglandin synthesis and can precipitate oliguric renal failure, so significantly impaired renal function, such as a creatinine around 2 mg/dL or marked oliguria, is a recognised contraindication. Other contraindications include active bleeding, suspected necrotising enterocolitis, and severe unconjugated hyperbilirubinaemia. A platelet count just above 100,000 is generally acceptable, and neither duct size nor gestational age at 29 weeks contraindicates therapy.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.