Andrianakis P, Walker D W, Ralph M M, Thorburn G D
Department of Physiology, Monash University, Clayton, Victoria, Australia.
Am J Obstet Gynecol. 1989 Jul;161(1):241-7. doi: 10.1016/0002-9378(89)90273-1.
Infusion of the prostaglandin synthetase inhibitor 4-aminoantipyrine at a rate of 20 mg/min via the fetal tarsal vein during normothermic conditions (ambient temperatures = 24 degrees C) significantly decreased the concentrations of prostaglandins E2 and F2 alpha in maternal and fetal arterial plasma and in uterine and umbilical vein plasma. The infusion was associated with a small but significant rise in fetal temperature and a fall in fetal arterial pH. Respiratory alkalosis developed in fetuses during hyperthermia by raising the ambient temperature to 43 degrees C for 8 hours. In contrast, infusion of 4-aminoantipyrine during hyperthermia produced fetal metabolic acidosis as indicated by a fall in fetal pH and an increase in PaCO2, even though the ewe remained hypocapnic. Four of the 10 fetuses died during or shortly after the 4-aminoantipyrine infusion during hyperthermia. These results indicate that uteroplacental prostaglandin synthesis is essential to allow the fetus to adapt to an increase in body temperature and suggests that prostaglandin synthetase inhibitors should be used with caution during pregnancy.
在常温条件下(环境温度 = 24摄氏度),以20毫克/分钟的速率通过胎儿跗骨静脉输注前列腺素合成酶抑制剂4-氨基安替比林,可显著降低母体和胎儿动脉血浆以及子宫和脐静脉血浆中前列腺素E2和F2α的浓度。输注与胎儿体温小幅但显著升高以及胎儿动脉pH值下降有关。通过将环境温度升至43摄氏度持续8小时,胎儿在高热期间出现呼吸性碱中毒。相比之下,高热期间输注4-氨基安替比林会导致胎儿代谢性酸中毒,表现为胎儿pH值下降和PaCO2升高,尽管母羊仍处于低碳酸血症状态。在高热期间输注4-氨基安替比林过程中或之后不久,10只胎儿中有4只死亡。这些结果表明,子宫胎盘前列腺素合成对于胎儿适应体温升高至关重要,并提示在怀孕期间应谨慎使用前列腺素合成酶抑制剂。