Kojima S, Ogura H, Yokoyama M, Ohkawa S
Nihon Sanka Fujinka Gakkai Zasshi. 1985 Dec;37(12):2784-90.
Diazepam was administered I.V. in 10mg doses to 26 normal women in labor, and its blood concentration in the mother and newborn, Apgar score and acid-base status in umbilical cord blood were determined immediately after delivery. The effect of diazepam on the neurobehavioral response of the newborn was evaluated by using the early neonatal neurobehavioral scale (ENNS) by Scanlon et al. Diazepam was swiftly transported into fetal blood through the placenta, to attain a higher blood concentration in the umbilical vein (UV) than in the maternal vein (MV) at 1-2 min after administration. The UV blood concentration of diazepam was always higher than the MV blood concentration, irrespective of the time between administration and delivery. A comparison of the blood concentration in the umbilical vein and the umbilical artery (UA), showed that the UV blood concentration was higher until 30 min after administration, but roughly eqalled the UA blood concentration thereafter. In terms of mean values in all the patients, the blood concentration in the UV (506 +/- 245 ng/ml) was significantly higher than that in the MV (350 +/- 204 ng/ml) or the UA (394 +/- 142 ng/ml). No significant difference was detected between the diazepam-treated group and the control in respect to the Apgar score, acid-base status in cord blood, neonatal serum bilirubin or time required for restration of the newborn to body weight at birth. The ENNS test showed suppression of nearly all the response immediately after birth, with suppression of response to pinprick, rooting response and sucking response persisting until 8 hr after birth.(ABSTRACT TRUNCATED AT 250 WORDS)
对26名正常分娩的女性静脉注射10毫克剂量的地西泮,分娩后立即测定母亲和新生儿体内的地西泮血药浓度、阿氏评分以及脐带血的酸碱状态。采用Scanlon等人的早期新生儿神经行为量表(ENNS)评估地西泮对新生儿神经行为反应的影响。地西泮通过胎盘迅速转运至胎儿血液中,给药后1 - 2分钟时,脐静脉(UV)中的血药浓度高于母静脉(MV)。无论给药与分娩之间的时间间隔如何,地西泮的脐静脉血药浓度始终高于母静脉血药浓度。脐静脉与脐动脉(UA)血药浓度的比较显示,给药后30分钟内脐静脉血药浓度较高,但此后大致与脐动脉血药浓度相等。就所有患者的平均值而言,脐静脉血药浓度(506±245纳克/毫升)显著高于母静脉(350±204纳克/毫升)或脐动脉(394±142纳克/毫升)。在地西泮治疗组与对照组之间,阿氏评分、脐带血酸碱状态、新生儿血清胆红素或新生儿恢复至出生体重所需时间方面未检测到显著差异。ENNS测试显示出生后几乎所有反应均受到抑制,对针刺的反应、觅食反应和吸吮反应的抑制持续至出生后8小时。(摘要截短至250字)