Impact of cocaine on human placental function using an in vitro perfusion system

The transport of cocaine from the maternal to fetal circulation and the effect of cocaine on placental function was investigated in vitro using dually perfused term human placentae with recirculation of both maternal and fetal perfusates. In the first experimental group (n = 5, 2 hr), after addition of 3H-cocaine and 14C-inulin to the maternal circulation, steady state concentrations were achieved within 20 min on the maternal side. However, in the following 100 min, uptake of 3H-cocaine remained higher than of the 14C-inulin on the maternal side. 3H-Cocaine was transported more rapidly than 14C-inulin into the fetal circulation and was detected within 10-15 min of initiation of perfusion. In the second experimental group (n = 6), the maternofetal permeability of 14C-insulin was determined in the same placental perfusion in both the absence (control period, 2 hr) and presence of cocaine (test phase, 2 hr) with its 3H-tracer. After the addition of cocaine (2-3 mg/L), the transfer of 14C-inulin was reduced from 6.59 to 3.64 mL/gm per min (p < .001), indicating that cocaine alters placental permeability. In addition to its effect on placental permeability, cocaine decreases the rate of release of hCG into the maternal circulation--reduced from 3.11 (control period) to 1.62 IU/min (test phase, p < .01).