Kuhn D C, Walenga R W, Stuart M J
Department of Pediatrics, SUNY Health Science Center, Syracuse.
Am J Perinatol. 1991 May;8(3):179-84. doi: 10.1055/s-2007-999372.
Placental blood flow is reduced in pregnancies complicated by hypertension, intrauterine growth retardation, maternal smoking, or diabetes. Umbilical-placental production of the potent vasodilator prostacyclin is also reduced in these pathologic states and this deficiency may contribute to an associated increase in the incidence of low infant birthweight by affecting a reduction in placental nutrient transfer. We have studied the effects of the prostacyclin analogue carbacyclin on diffusional transfer in the human placenta perfused in vitro. We have found that carbacyclin crosses the human placenta and can significantly increase diffusional transfer in placenta from pregnancies complicated by hypertension or maternal smoking and in the normal term placenta in which prostacyclin production has first been reduced through the administration of ibuprofen. Carbacyclin had no effect, however, in untreated placenta from normal pregnancies or in placenta from diabetic pregnancies. These results suggest that the prostacyclin-deficient perfused placenta may serve as a model for several placental insufficiency syndromes and that the possibility that prostacyclin analogues may improve deficient nutrient transfer in some pathologic pregnancies warrants further investigation.
在患有高血压、胎儿宫内生长受限、孕妇吸烟或糖尿病的妊娠中，胎盘血流量会减少。在这些病理状态下，脐-胎盘产生的强效血管舒张剂前列环素也会减少，这种缺乏可能通过影响胎盘营养物质转运的减少，导致低出生体重婴儿的发生率相应增加。我们研究了前列环素类似物卡巴前列素对体外灌注的人胎盘扩散转运的影响。我们发现，卡巴前列素可穿过人胎盘，并能显著增加患有高血压或孕妇吸烟的妊娠胎盘以及足月正常胎盘（其中通过给予布洛芬首先降低了前列环素的产生）的扩散转运。然而，卡巴前列素对正常妊娠未经治疗的胎盘或糖尿病妊娠的胎盘没有影响。这些结果表明，前列环素缺乏的灌注胎盘可能作为几种胎盘功能不全综合征的模型，并且前列环素类似物可能改善某些病理妊娠中营养物质转运不足的可能性值得进一步研究。
