Stek A M, Baker R S, Fisher B K, Lang U, Clark K E
Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, OH 45267-0526, USA.
Am J Obstet Gynecol. 1995 Nov;173(5):1592-8. doi: 10.1016/0002-9378(95)90654-1.
The current study was designed to test the hypothesis that maternally administered methamphetamine decreases fetal PaO2 by reducing uterine blood flow and to determine the cardiovascular and blood gas responses to varying doses of methamphetamine given both to the fetus and the mother.
Nine near-term pregnant sheep were surgically instrumented to measure maternal and fetal blood pressure and heart rate and uterine and umbilical blood flow. Fetal blood gases and pH were determined before and after each dose of methamphetamine. Methamphetamine was administered as intravenous bolus injections (30 to 35 minutes separating administration of each dose) into the maternal femoral vein in increasing doses of 0.03, 0.1, 0.3, and 1.0 mg/kg and on a separate days to the fetus into the hind limb vein as doses of 0.03, 0.1, 0.3, 1.0, and 3.0 mg/kg estimated fetal weight.
Maternal methamphetamine administration produced a dose-related increase in maternal and fetal blood pressure and uterine vascular resistance, whereas uterine blood flow decreased in a dose-related fashion. Umbilical blood flow tended to increase slightly, but this did not reach significance. Fetal PaO2 decreased significantly, whereas fetal pH decreased only modestly. Direct fetal administration of methamphetamine produced dose-related increases in fetal blood pressure and umbilical blood flow and a significant decrease in fetal pH but no change in fetal PaO2.
The fetal PaO2 decrease observed after maternal administration of methamphetamine appears to be a result of decreased uteroplacental perfusion, whereas the observed changes in fetal blood pressure and fetal pH appear to be a result of the direct action of methamphetamine on the fetus.
本研究旨在验证以下假设,即母体使用甲基苯丙胺会通过减少子宫血流量来降低胎儿的动脉血氧分压(PaO2),并确定胎儿和母体给予不同剂量甲基苯丙胺后的心血管及血气反应。
对9只近足月妊娠绵羊进行手术,以测量母体和胎儿的血压、心率以及子宫和脐血流量。在每次给予甲基苯丙胺前后测定胎儿的血气和pH值。甲基苯丙胺以静脉推注的方式给药(每次给药间隔30至35分钟),母体股静脉给药剂量递增,分别为0.03、0.1、0.3和1.0mg/kg,在不同日期以估计胎儿体重的0.03、0.1、0.3、1.0和3.0mg/kg的剂量经后肢静脉给予胎儿。
母体给予甲基苯丙胺后,母体和胎儿血压以及子宫血管阻力呈剂量依赖性增加,而子宫血流量呈剂量依赖性减少。脐血流量略有增加趋势,但未达到显著水平。胎儿PaO2显著降低,而胎儿pH值仅略有下降。直接给胎儿使用甲基苯丙胺会使胎儿血压和脐血流量呈剂量依赖性增加,胎儿pH值显著降低,但胎儿PaO2无变化。
母体给予甲基苯丙胺后观察到的胎儿PaO2降低似乎是子宫胎盘灌注减少的结果,而观察到的胎儿血压和胎儿pH值变化似乎是甲基苯丙胺对胎儿直接作用的结果。