Kovac Christine M, Howard Bobby C, Pierce Brian T, Hoeldtke Nathan J, Calhoun Byron C, Napolitano Peter G
Division of Maternal-Fetal Medicine, Madigan Army Medical Center, Tacoma, Wash., USA.
Am J Obstet Gynecol. 2003 Sep;189(3):839-42. doi: 10.1067/s0002-9378(03)00851-2.
The purpose of this study was to evaluate fetoplacental vascular tone and response to a vasoconstrictor in placentas of preeclamptic and normotensive pregnancies with and without the presence of magnesium sulfate.
Two cotyledons from each placenta were selected from preeclamptic (n=8) and normotensive (n=7) pregnancies. In one cotyledon from each pair, the maternal circuit was perfused with magnesium sulfate. The fetal arteries were injected sequentially with angiotensin II (10(-10)mol and 10(-11.5) mol). Perfusion pressures and response to angiotensin II were compared, with regard to preeclampsia and exposure to magnesium sulfate.
Perfusion pressure was higher in preeclamptic placentas, compared with normotensive placentas (30.4 mm Hg vs 24.4 mm Hg, P=.02). There was a decrease in perfusion pressure with exposure to magnesium sulfate in preeclamptic placentas (22.5 mm Hg, P<.01), but not in normotensive placentas. Fetoplacental vascular response to angiotensin II was not affected by preeclampsia or magnesium sulfate.
In placentas from preeclamptic pregnancies there is increased fetoplacental perfusion pressure, which decreases with exposure to sulfate.
本研究旨在评估子痫前期和血压正常孕妇胎盘的胎儿 - 胎盘血管张力以及对血管收缩剂的反应,这些孕妇有的使用了硫酸镁,有的未使用。
从子痫前期(n = 8)和血压正常(n = 7)孕妇的胎盘中各选取两个子叶。在每对子叶中,其中一个子叶的母体循环用硫酸镁灌注。依次向胎儿动脉注射血管紧张素 II(10⁻¹⁰mol 和 10⁻¹¹·⁵mol)。比较子痫前期和硫酸镁暴露情况下的灌注压力及对血管紧张素 II 的反应。
与血压正常的胎盘相比,子痫前期胎盘的灌注压力更高(30.4 毫米汞柱对 24.4 毫米汞柱,P = 0.02)。子痫前期胎盘暴露于硫酸镁后灌注压力降低(22.5 毫米汞柱,P < 0.01),而血压正常的胎盘则未降低。胎儿 - 胎盘血管对血管紧张素 II 的反应不受子痫前期或硫酸镁的影响。
子痫前期孕妇的胎盘胎儿 - 胎盘灌注压力升高,暴露于硫酸镁后压力降低。