Harper A, Murnaghan G A
Department of Obstetrics and Gynaecology, Queen's University of Belfast.
Br J Obstet Gynaecol. 1991 May;98(5):453-9. doi: 10.1111/j.1471-0528.1991.tb10339.x.
Intravenous treatment with 10 mg of hydralazine or 100 mg of labetalol was randomly allocated to 30 hypertensive pregnant women. Umbilical artery flow velocity waveforms were recorded using a pulsed Doppler duplex scanner (ATL Mk V) and umbilical artery pulsatility index (PI) and fetal heart rate (FHR) were derived from these recordings. Maternal blood pressure decreased significantly after both drugs. Maternal pulse rate increased after hydralazine but did not change significantly after labetalol. FHR did not change significantly after hydralazine but decreased after labetalol. PI decreased after hydralazine and increased after labetalol--most fetuses showed little change but a few in each group showed large changes in PI, as did two of five additional patients studied. We attributed the decrease in PI in some fetuses after hydralazine to vasodilation, and the increase in PI in some fetuses after labetalol to vasoconstriction in the fetoplacental circulation, suggesting that fetal beta-blockade may occur after maternal treatment with labetalol.
将10毫克肼屈嗪或100毫克拉贝洛尔的静脉治疗随机分配给30名高血压孕妇。使用脉冲多普勒双功扫描仪（ATL Mk V）记录脐动脉血流速度波形，并从这些记录中得出脐动脉搏动指数（PI）和胎儿心率（FHR）。两种药物治疗后孕妇血压均显著下降。肼屈嗪治疗后孕妇脉搏率升高，但拉贝洛尔治疗后无显著变化。肼屈嗪治疗后FHR无显著变化，但拉贝洛尔治疗后下降。肼屈嗪治疗后PI下降，拉贝洛尔治疗后升高——大多数胎儿变化不大，但每组中有少数胎儿PI变化较大，另外研究的五名患者中有两名也是如此。我们将肼屈嗪治疗后部分胎儿PI下降归因于血管舒张，将拉贝洛尔治疗后部分胎儿PI升高归因于胎儿胎盘循环中的血管收缩，这表明孕妇使用拉贝洛尔治疗后可能会发生胎儿β受体阻滞。
