胎児前ベタメタゾンの投与が胎盤血管抵抗に与える影響
1Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia. Euan.Wallace@med.monash.edu.au
Lancet (London, England)
|May 5, 1999
まとめ
ベタメタゾンの投与は,終末ダイアストリックフローがない妊娠における胎児胎盤血流を改善し,胎盤血管抵抗を低下させた. この介入が胎児に有益かどうかを判断するために,さらなる研究が必要である.
科学分野:
- ペリナトロジー (Perinatology) とは
- 妊産婦・胎児医学について
- 胎児生理学 胎児生理学
背景:
- 高度の胎盤血管抵抗は,胎児の成長制限と胎内死亡率の重要な要因です.
- 現在の管理は,監視と出産に焦点を当てており,胎盤の血流を改善するための治療の選択肢が欠如しています.
- 胎盤のコルチコトロピン放出ホルモン (CRH) は潜在的血管拡張剤であり,コルチコステロイドは,その分泌を増強する可能性があります.
研究 の 目的:
- 胎盤血管抵抗が増加した妊娠における胎盤血流に対するコルチコステロイドの効果を調査する.
- ベタメタゾンの投与が,無端ダイアストリックフロー (AEDF) の場合,胎盤の血管抵抗を低下させることができるかどうかを判断する.
主な方法:
- 動脈の流れ速度波形 (FVWs) をAEDF.で28人の妊娠で遡及的に検討した.
- FVWは,パルス波ドップラー超音波を用いてベタメタゾン投与前後に評価されました.
- 収集されたデータには,プレゼンテーション時の妊娠年齢と動脈のダイアストリックフローの変化が含まれています.
主要な成果:
- 妊娠の68%では,ベタメタゾンの投与から24時間以内に動脈のダイアストリックフローが戻った.
- 胎盤血管抵抗の減少は,平均3日間続いた.
- 出産時の妊娠年齢や出産時の出生体重において,フロー・リターンとフロー・リターンのない胎児の間で有意な差異は認められませんでした.
結論:
- ベタメタゾン治療は,動脈AEDFの妊娠における胎盤血管抵抗の低下と関連しています.
- この効果は,胎盤のCRH分泌の増加によって媒介される可能性があります.
- この介入が胎児の結末に与える臨床的利益や害は,未だに決定されていない.
関連する概念動画
Adrenergic Antagonists: ɑ and β-Receptor Blockers
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is clinically...
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Development of Blood Vessels
The development of the vascular system in a fetus is a complex and intricate process that begins as early as 15 to 16 days post-conception. This process starts outside the embryo, specifically in the mesoderm of the yolk sac, chorion, and connecting stalk. Approximately two days later, the formation of blood vessels occurs within the embryo itself.
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
Fetal Circulation
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...


