Hemodynamic changes after chronic pindolol administration in pregnant renal hypertensive rats.

Y Lundgren, U Ljungblad, K Karlsson
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Abstract

The aim of the present study on pregnant renal hypertensive rats was to investigate the effects on central hemodynamics and uteroplacental blood flow after chronic administration of pindolol, a nonspecific beta-adrenergic receptor blocking agent with intrinsic beta-stimulatory effect. Renal hypertension was induced by partial clamping of both renal arteries four weeks before pregnancy. Pindolol was administered with the food during the entire pregnancy period. Two to four days before expected delivery mean arterial pressure, heart rate, cardiac output, (dye-dilution technique) and utero-placental blood supply (microsphere technique) were determined. The chronic pindolol treatment reduced heart rate by 25 per cent while both mean arterial pressure and cardiac output remained unchanged. However, blood flow to uterus and placentae was reduced by 43 and 64 per cent, respectively, after pindolol treatment. Clinical as well as experimental studies (15, 16) demonstrate a reduced utero-placental blood supply when pregnancies are complicated by hypertension. As pregnancies with severe hypertension are associated with an increased frequency of intrauterine growth retardation and intrauterine asphyxia the present results indicate that the combination of hypertension and long-term treatment with beta-blockers might reduce utero-placental blood flow enough as to seriously interfere with fetal oxygen supply thereby increasing the risk of intra- and extra-uterine asphyxia.

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慢性品多洛尔对妊娠肾性高血压大鼠血流动力学的影响。
本实验以妊娠肾性高血压大鼠为研究对象,探讨慢性给予非特异性β -肾上腺素能受体阻滞剂品多洛尔对妊娠肾性高血压大鼠中枢血流动力学和子宫胎盘血流的影响。妊娠前4周,双肾动脉部分夹持诱导肾性高血压。品多洛尔在整个怀孕期间与食物一起服用。在预产期前2 ~ 4天测定平均动脉压、心率、心输出量(染料稀释法)和子宫胎盘血供(微球法)。慢性品多洛尔治疗使心率降低了25%,而平均动脉压和心输出量保持不变。然而,经品多洛尔治疗后,子宫和胎盘的血流量分别减少了43%和64%。临床和实验研究(15,16)表明,当妊娠合并高血压时,子宫-胎盘血供减少。重度高血压妊娠与宫内生长迟缓和宫内窒息的发生频率增加有关,目前的研究结果表明,高血压和β受体阻滞剂的长期联合治疗可能会减少子宫-胎盘血流量,从而严重干扰胎儿的氧气供应,从而增加子宫内和子宫外窒息的风险。
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Pre-eclampsia in a second pregnancy. A clinical follow-up study of 260 women with hypertension in pregnancy. Beta blocker therapy in 125 cases of hypertension during pregnancy. Disposition of the adrenergic blocker metoprolol in the late pregnant women, the amniotic fluid, the cord blood and the neonate. Maternal-fetal immunity: presence of specific cellular hyporesponsiveness and humoral suppressor activity in normal pregnancy and their absence in preeclampsia.
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