Placental transport of metoclopramide: assessment of maternal and neonatal effects

Twenty-three patients undergoing general anaesthesia for Caesarian section for healthy term pregnancies were entered into a double blind study using metoclopramide (MCP) and a normal saline placebo. Of these patients, eight received intravenous metoclopramide, 12 a normal saline placebo and three were lost to clinical follow-up. The maternal gastric volumes were measured and maternal and foetal MCP plasma concentrations were determined by gas-liquid chromatography. The Neurological and Adaptive Capacity Score tests of Amiel, Barrier and Schnider (NACS) were used to attempt evaluation of neonatal responses to MCP. Maternal gastric volume was significantly lower (p less than 0.05) in the treated patients. There were no marked differences in Apgar scores, cardiovascular parameters or neurobehavioural scores between the treated and untreated groups of neonates. At no time were the foetal metoclopramide plasma concentrations observed to exceed maternal values.