Department of Pediatric Cardiology, Second University Hospital and West China Medical School, Sichuan University, Chengdu 610041, China.
J Biomed Sci. 2012 Aug 13;19(1):74. doi: 10.1186/1423-0127-19-74.
Intrauterine balloon aortic valvuloplasty (IUBAV) has been used for critical aortic stenosis. However, it is necessary to determine the fetal impairments such as preterm birth after this approach and to find a way to prevent or reduce them.
In the present study, we evaluated the therapeutic value of indomethacin (IDM) and dexamethasone (DXS) on reducing the preterm birth rate in experimental goats after IUBAV.
Our results indicated that the administration of IDM/DXS significantly reduced the rate of premature birth. IDM/DXS treatment led to preservation of myocardial ultrastructure with less damage, and amelioration of the fetal and placental circulation. Furthermore, we found that norepinephrine (NE) level was positively associated with the degree of myocardial damage. IDM/DXS administration led to a significant decrease of operation-induced increase of NE levels, which may be associated with the protective effects of IDM/DXS. Lastly, we found that the administration of IDM/DXS did not induce the risk of ductus arteriosus closure or slow down fetal growth.
Our results indicate that IDM/DXS promotes a better gestational outcome at least partially by reducing stress response during and after the operation of IUBAV in the goat model. IDM/DXS may be a useful application in human patients during IUBAV intervention.
宫内球囊主动脉瓣成形术（IUBAV）已被用于治疗严重的主动脉瓣狭窄。然而，有必要确定这种方法后胎儿的损伤，如早产，并找到预防或减少这些损伤的方法。
在本研究中，我们评估了吲哚美辛（IDM）和地塞米松（DXS）在 IUBAV 后降低实验山羊早产率的治疗价值。
我们的结果表明，IDM/DXS 的给药显著降低了早产率。IDM/DXS 治疗导致心肌超微结构的损伤减少，胎儿和胎盘循环得到改善。此外，我们发现去甲肾上腺素（NE）水平与心肌损伤程度呈正相关。IDM/DXS 给药导致手术引起的 NE 水平升高显著降低，这可能与 IDM/DXS 的保护作用有关。最后，我们发现 IDM/DXS 的给药并没有增加动脉导管未闭的风险或减缓胎儿生长。
我们的结果表明，IDM/DXS 通过减少宫内球囊主动脉瓣成形术（IUBAV）过程中和之后的应激反应，至少部分地促进了妊娠结局的改善。IDM/DXS 可能在 IUBAV 干预期间对人类患者有用。
