Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Department of Biomolecular Science, Fukushima Medical University School of Medicine, Fukushima, Japan.
PLoS One. 2022 Mar 31;17(3):e0265872. doi: 10.1371/journal.pone.0265872. eCollection 2022.
Ritodrine hydrochloride is used for pregnancy prolongation and intrauterine fetal resuscitation. However, its clinical significance in intraamniotic inflammation during preterm labor and intrauterine fetal distress is unclear. We investigated the effects of maternal ritodrine hydrochloride administration (MRA; 200 μg/min for 2 h, followed by 800 μg/min for 2 h after 24 h) on fetal physiological parameters. For this purpose, we used chronically instrumented pregnant sheep at 113-119 d (term = 145 d) of gestation without (Group 1, n = 5) and with (Group 2, n = 5) intraamniotic inflammation induced by lipopolysaccharide injection into the amniotic cavity. The changes in fetal heart rate (FHR) and short-term variability (STV) and long-term variability (LTV) in FHR, fetal blood pressure, and fetal arterial blood gas (FABG) values were measured before and at 1 and 2 h after initiating MRA. Before MRA, all parameters were similar between Groups 1 and 2; however, there was significantly higher STV in Group 2 than in Group 1 before MRA at 800 μg/min, significantly higher partial arterial pressure of carbon dioxide in FABG in Group 2 than in Group 1 before MRA at 200 μg/min, and significantly lower blood glucose (BG) in Group 2 than in Group 1 before MRA at 800 μg/min. One hour after MRA, the FHR, STV, and LTV were significantly higher at 800 μg/min than those at the baseline in Group 1, as determined by the Friedman test; however, no significant difference was observed in Group 2. Additionally, the FABG pH significantly decreased 1 h after MRA at 800 μg/min in Group 2, whereas FABG lactate and BG significantly increased 2 h after MRA at 800 μg/min in Groups 1 and 2. Thus, short-term MRA at 800 μg/min increased the FHR, STV, and LTV significantly; these values were further modified under intraamniotic inflammation.
盐酸利托君用于延长妊娠和宫内胎儿复苏。然而，其在早产伴宫内炎症和胎儿宫内窘迫中的临床意义尚不清楚。我们研究了母亲盐酸利托君给药（MRA；24 小时后 2 小时内 200μg/min，然后 800μg/min）对胎儿生理参数的影响。为此，我们在 113-119 天（足月=145 天）的慢性仪器化妊娠绵羊中进行了研究，这些绵羊没有（第 1 组，n=5）和有（第 2 组，n=5）通过向羊膜腔注射脂多糖引起的宫内炎症。在开始 MRA 之前和之后 1 小时和 2 小时测量胎儿心率（FHR）和短期可变性（STV）以及 FHR 的长期可变性（LTV）、胎儿血压和胎儿动脉血气（FABG）值。在 MRA 之前，两组之间的所有参数均相似；然而，在 MRA 之前 800μg/min 时，第 2 组的 STV 明显高于第 1 组，在 MRA 之前 200μg/min 时第 2 组的 FABG 中二氧化碳分压明显高于第 1 组，在 MRA 之前 800μg/min 时第 2 组的血糖（BG）明显低于第 1 组。MRA 后 1 小时，通过 Friedman 检验发现，第 1 组在 MRA 之前 800μg/min 时 FHR、STV 和 LTV 明显高于基线，而第 2 组无显著差异。此外，在 MRA 之后 800μg/min 时第 2 组的 FABG pH 在 1 小时后显著降低，而在 MRA 之后 800μg/min 时第 1 组和第 2 组的 FABG 乳酸和 BG 显著增加。因此，在宫内炎症下，短期 MRA 以 800μg/min 增加 FHR、STV 和 LTV；这些值在 MRA 后 2 小时进一步改变。
