Tambyraja R L
Department of Obstetrics & Gynaecology, National University of Singapore.
Ann Acad Med Singap. 1987 Apr;16(2):281-5.
The study of drug distribution in pregnancy was limited by ethical, technical and medico-legal considerations as samples of body fluids could only be taken at delivery. In recent times fetal blood samples have been taken with the fetoscope and will provide a new tool to monitor fetal concentrations and metabolic pathways. The advanced technology of ultrasound allows non invasive study of the fetal circulation and early experience of sympathomimetic drugs administered to the mother will be discussed. Auto immune disorders carry high perinatal wastage. New drugs have made reproductive life possible and when used prudently can improve maternal state and increase fetal salvage. The author has personally managed nearly 52 cases of systemic lupus erythematosus and 16 cases of idiopathic thrombocytopenic purpura. The use of steroids and low dosage aspirin therapy with elevated lupus anticoagulant levels will be described. Two cases of early hydrops in the fetus owing to heart failure due to supraventricular tachycardia were treated with digoxin given to the mother. The potential of therapeutic agents in fetal medicine will be discussed as it recognises the fetus as a patient and provides effective intra uterine therapy.
由于伦理、技术和医学法律方面的考虑，孕期药物分布的研究受到限制，因为体液样本只能在分娩时采集。近年来，已通过胎儿镜采集胎儿血样，这将为监测胎儿药物浓度和代谢途径提供一种新工具。先进的超声技术能够对胎儿循环进行无创研究，本文还将讨论给母亲使用拟交感神经药物的早期经验。自身免疫性疾病导致围产期高损耗率。新药使生殖成为可能，谨慎使用时可改善母体状况并提高胎儿存活率。作者个人处理过近52例系统性红斑狼疮和16例特发性血小板减少性紫癜病例。本文将描述使用类固醇和低剂量阿司匹林治疗狼疮抗凝物质水平升高的情况。两例因室上性心动过速导致心力衰竭而出现早期胎儿水肿的病例，通过给母亲使用地高辛进行了治疗。胎儿医学中治疗药物的潜力将得到讨论，因为它将胎儿视为患者并提供有效的宫内治疗。
