Balancing Benefits and Risks of Indomethacin in the Management of Antenatal Bartter Syndrome: A Case Report.

Background: Bartter syndrome, a very rare inherited renal tubular disorder, characterized by urinary salt wastage, hypokalemia, polyuria, and metabolic alkalosis, may manifest antenatally as severe isolated polyhydramnios. Indomethacin is known to reduce salt wastage and subsequent polyhydramnios during pregnancy; however, it reduces the Ductus Arteriosus diameter among other potential complications, such as inhibition of gastrointestinal perfusion and increasing the risk of renal toxicity.

Case: A 36-year-old multigravida presented with severe isolated polyhydramnios at 30 weeks of gestation.