Forestier F, Daffos F, Rainaut M, Desnottes J F, Gaschard J C
Centre de Diagnostic Prénatal et de Foetologie, Hôpital Notre-Dame-de-Bon-Secours, Paris.
Arch Fr Pediatr. 1987 Aug-Sep;44(7):539-44.
In the preventive treatment of congenital toxoplasmosis it is admitted that spiramycin is concentrated in the placenta and crosses the placental barrier at the end of pregnancy. However, little is known about its entry in the fetal circulation. We studied fetal spiramycin blood levels during the 2nd and 3rd trimesters of pregnancy in women who, having presented with toxoplasmosis during the 1st trimester, had been given spiramycin until delivery. Microbiological titrations of spiramycin were performed--in the maternal blood at the onset of treatment, at the time of fetal blood sampling and during delivery), in the fetal blood at the time of prenatal diagnosis of toxoplasmosis, in cord blood and placenta at birth. We were able to confirm transplacental crossing of spiramycin. Fetal blood levels during the 2nd trimester were about 47% of the maternal ones and there was no correlation between maternal and fetal levels. Levels at birth showed that (1) there was no accumulation in the course of treatment, (2) spiramycin was concentrated in placenta and (3) there was a correlation between fetal and maternal levels during the 3rd trimester.
在先天性弓形虫病的预防性治疗中，人们公认螺旋霉素可在胎盘内蓄积，并在妊娠末期穿过胎盘屏障。然而，关于其进入胎儿循环的情况却知之甚少。我们研究了在妊娠前三个月患弓形虫病且一直服用螺旋霉素直至分娩的妇女在妊娠中期和晚期的胎儿螺旋霉素血药浓度。进行了螺旋霉素的微生物滴定——在治疗开始时、采集胎儿血样时和分娩时的母体血液中，在弓形虫病产前诊断时的胎儿血液中，以及出生时的脐血和胎盘中。我们能够证实螺旋霉素可经胎盘转运。妊娠中期胎儿血药浓度约为母体血药浓度的47%，且母体与胎儿血药浓度之间无相关性。出生时的血药浓度表明：（1）治疗过程中无蓄积现象；（2）螺旋霉素在胎盘中蓄积；（3）妊娠晚期胎儿与母体血药浓度之间存在相关性。
