Transplacental Passage (transplacental + passage)

Distribution by Scientific Domains


Selected Abstracts


Influence of P-glycoprotein on the transplacental passage of cyclosporine

JOURNAL OF PHARMACEUTICAL SCIENCES, Issue 10 2001
P. Pávek
Abstract The transfer kinetics of cyclosporine across the dually perfused rat placenta in the maternal to fetal direction and a possible involvement of P-glycoprotein were investigated. The transplacental clearance of cyclosporine in the materno,fetal direction was found to be dependent on the maternal inflow concentration of cyclosporine. Coadministration of cyclosporine with an excess of quinidine or chlorpromazine into the maternal compartment revealed 1.7- and 1.9-fold increase in cyclosporine concentration in the fetal compartment. In the experiments where quinidine was present both in the maternal and fetal compartments, cyclosporine appeared in the fetal compartment significantly faster, and its amount was three times higher when compared with controls. Conversely, quinidine or chlorpromazine did not affect the transplacental passage of L-[3H]-glucose. The interference of quinidine with the metabolism of cyclosporine in the placenta was excluded because only traces of M-1 and M-17 metabolites were found in the fetal solutions. Sodium azide, a mitochondrial respiratory inhibitor, was found to double the rate of cyclosporine, but not L-[3H]-glucose, passage across the placenta. Our findings indicate that P-glycoprotein pumps cyclosporine out of the trophoblast cells of the rat placenta in the ATP-dependent manner and restricts the passage of cyclosporine across the placental barrier. © 2001 Wiley-Liss, Inc. and the American Pharmaceutical Association J Pharm Sci 90:1583,1592, 2001 [source]


Anesthesia in HIV-infected children

PEDIATRIC ANESTHESIA, Issue 6 2007
RUENREONG LEELANUKROM
Summary In 2005, it was estimated that 2.3 million children below15 years of age were living with human immunodeficiency virus (HIV)/AIDS and 570 000 children below 15 years died. Maternal-infant or vertical transmission is the most common mode of HIV infection in children. As transplacental passage of maternal anti-HIV antibodies, diagnosis of HIV infection in young infants relies on virologic assays. Infants older than 18 months of age can be diagnosed by serology alone. Pediatric HIV infections are classified according to Center for Disease Control and Prevention 1994 revised classification system. The understanding of viral pathogenesis, the development of highly active antiretroviral therapy, and the ability to quantitate viral burden have led to significant reduction in disease progression and morbidity in HIV-infected children. As survival improves, these children will require anesthesia care and pain treatment during the course of their illness. Considerations for the anesthesiologist include: possible involvement of multiple organ systems, adverse reactions and drug interactions of antiretroviral agents and adequate infection control to prevent HIV transmission in hospital and other infections to the immunocompromized patients. Finally, care should be taken not to violate confidentiality. [source]


Is breast-feeding of infants advisable for epileptic mothers taking antiepileptic drugs?

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2010
Lei Chen MD
Epilepsy is a relatively common maternal complication affecting 0.3,0.5% of pregnant women. For most mothers with epilepsy, the use of antiepileptic drugs (AED) is unavoidable, even during pregnancy and lactation. Therefore, the fetus is indirectly exposed to AED via the placenta and breast milk. AED are also prescribed for female patients with other diseases, such as bipolar disorders. In clinical settings, physicians are frequently questioned whether or not women patients taking AED should breast-feed their offspring. Thus, it is necessary to establish an optimum AED regimen for women taking AED, in particular for those with epilepsy during pregnancy and lactation. In this article, we critically review the effects of AED on infants via breast milk and attempt to provide suggestions for clinicians regarding these effects during breast-feeding, based on the data of transplacental passage of AED, breast milk concentration/maternal serum concentration ratios, AED metabolism in infants and the effects of AED in breast milk on infants. [source]


Failure of intravenous immunoglobulin to prevent congenital heart block: Findings of a multicenter, prospective, observational study

ARTHRITIS & RHEUMATISM, Issue 4 2010
C. N. Pisoni
Objective Congenital heart block (CHB) is presumed to be caused by transplacental passage of maternal immunoglobulin against Ro and La ribonucleoproteins. The recurrence rate in subsequent pregnancies following the birth of a child with CHB is ,19%. The purpose of this study was to determine whether intravenous immunoglobulin (IVIG) therapy could prevent the development of CHB in the fetuses of high-risk pregnant women. Methods A total of 24 pregnancies in 22 women who had a previous pregnancy in which CHB developed, were over the age of 18 years, were <12 weeks pregnant, and had anti-Ro, anti-La, or both antibodies were monitored in this multicenter, prospective, observational study. Fifteen patients received infusions of IVIG. The 9 pregnancies in the remaining 7 patients served as controls. IVIG was administered at a dose of 400 mg/kg at weeks 12, 15, 18, 21, and 24 of pregnancy. Echocardiograms were performed at least every 3 weeks from week 15 to week 30 of gestation. Electrocardiograms were obtained at birth. The outcome measure was the development of third-degree CHB detected by fetal echocardiogram. Results CHB developed in 3 babies among the 15 pregnancies in the treatment group (20%) and in 1 baby among the 9 pregnancies in the control group (11%). CHB was detected at weeks 18, 23, and 26, respectively, in the 3 babies in the treated group and at week 19 in the baby in the control group. Three of the affected pregnancies ended in termination; 2 for reasons related to the fetal disease and 1 for reasons related to both maternal (severe pulmonary hypertension) and fetal disease (at 21 weeks of gestation). Conclusion IVIG at the dose and frequency used in this study was not effective as prophylactic therapy for CHB in high-risk mothers. [source]


Evidence of transplacental passage of hydroxychloroquine in humans

ARTHRITIS & RHEUMATISM, Issue 4 2002
Nathalie Costedoat-Chalumeau MD
No abstract is available for this article. [source]