Anti-hypertensive therapy and the feto-placental circulation: effects on umbilical artery resistance
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D.D. Houlihan
Abstract
Objective: To investigate and compare the direct effects of compounds used in the treatment of hypertensive disease in pregnancy on human umbilical artery resistance in vitro.
Methods: Isometric tension recordings were performed under physiological conditions on human umbilical arterial rings (n=30). The in vitro effects of labetolol, hydralazine, alpha-methyldopa, nifedepine and magnesium sulphate (at concentration ranges from 1 nanomolar to 1 millimolar), and their respective vehicle controls, were measured. Results were expressed as −logEC50 (pD2) and mean maximal inhibition values for each compound.
Results: All compounds investigated, except alpha methyldopa, exerted a significant relaxant effect on umbilical arterial tone. Alpha-methyldopa was significantly less potent when compared to all other compounds (mean maximal inhibition value [20.89±7.99%] versus all other agents [range 63.15±8.70−84.12±3.84%] (P<0.01)). The dose response curve of nifedipine yielded a significantly greater pD2 value when compared to that of hydralazine, labetalol, and magnesium sulphate (pD2 value [5.82±0.34] versus the above groups [range 3.10±0.09−3.52±0.14] (P<0.01)).
Conclusion: These findings demonstrate that agents commonly used for the treatment of hypertensive disease in pregnancy, excluding alpha-methyldopa, have significant direct effects on the feto-placental circulation. These results suggest that alpha-methyldopa administration during pregnancy is less likely to produce significant direct effects on fetal vasculature then other agents used.
Copyright © 2004 by Walter de Gruyter GmbH & Co. KG
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