Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model
We hypothesized that nifedipine and sildenafil would have no detrimental effects on placental hemodynamics and gas exchange under fetal hypoxemia. In 33 chronically instrumented fetal sheep, placental volume blood flow (QPlac) and umbilical artery (UA) vascular impedance were measured by Doppler ult...
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| Veröffentlicht in: | Placenta (Eastbourne) 2020-01, Vol.90, p.103-108 |
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| creator | Alanne, Leena Bhide, Amarnath Hoffren, Jonna Lantto, Juulia Huhta, Heikki Kokki, Merja Haapsamo, Mervi Acharya, Ganesh Räsänen, Juha |
| description | We hypothesized that nifedipine and sildenafil would have no detrimental effects on placental hemodynamics and gas exchange under fetal hypoxemia.
In 33 chronically instrumented fetal sheep, placental volume blood flow (QPlac) and umbilical artery (UA) vascular impedance were measured by Doppler ultrasonography. Fetal carotid artery blood pressure and blood gas values were monitored. After baseline data collection, maternal and fetal hypoxemia were induced. Following hypoxemia phase data collection, 12 fetuses received sildenafil and 9 fetuses nifedipine infusion, and 12 fetuses served as controls receiving saline infusion. Data were collected 30 and 120 min after infusion was started. Then maternal oxygenation was normalized and normoxemia phase data were collected, while infusion was continued.
Hypoxemia significantly decreased fetal pO2 and blood pressure. In the sildenafil group at 30- and 120-min hypoxemia + infusion phases, fetal blood pressure and QPlac were significantly lower and pCO2 higher than at baseline without returning to baseline level at normoxemia + infusion phase. In hypoxemia, nifedipine did not affect fetal blood pressure or placental hemodynamics. Both in the sildenafil and nifedipine groups, fetal pO2 remained significantly lower at normoxemia + infusion phase than in the control group. Umbilical artery vascular impedance did not change during the experiment.
In fetal hypoxemia, sildenafil had detrimental effects on placental hemodynamics that disturbed placental gas exchange. Nifedipine did not alter placental hemodynamics in hypoxemia but disturbed placental gas exchange upon returning to normoxemia. Umbilical artery vascular impedance did not reflect alterations in placental hemodynamics.
•Sildenafil decreased fetal blood pressure and placental blood flow in hypoxemia.•Nifedipine did not disturb placental blood flow in fetal hypoxemia.•Umbilical artery vascular impedance did not reflect placental hemodynamic changes. |
| doi_str_mv | 10.1016/j.placenta.2019.12.014 |
| format | Article |
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In 33 chronically instrumented fetal sheep, placental volume blood flow (QPlac) and umbilical artery (UA) vascular impedance were measured by Doppler ultrasonography. Fetal carotid artery blood pressure and blood gas values were monitored. After baseline data collection, maternal and fetal hypoxemia were induced. Following hypoxemia phase data collection, 12 fetuses received sildenafil and 9 fetuses nifedipine infusion, and 12 fetuses served as controls receiving saline infusion. Data were collected 30 and 120 min after infusion was started. Then maternal oxygenation was normalized and normoxemia phase data were collected, while infusion was continued.
Hypoxemia significantly decreased fetal pO2 and blood pressure. In the sildenafil group at 30- and 120-min hypoxemia + infusion phases, fetal blood pressure and QPlac were significantly lower and pCO2 higher than at baseline without returning to baseline level at normoxemia + infusion phase. In hypoxemia, nifedipine did not affect fetal blood pressure or placental hemodynamics. Both in the sildenafil and nifedipine groups, fetal pO2 remained significantly lower at normoxemia + infusion phase than in the control group. Umbilical artery vascular impedance did not change during the experiment.
In fetal hypoxemia, sildenafil had detrimental effects on placental hemodynamics that disturbed placental gas exchange. Nifedipine did not alter placental hemodynamics in hypoxemia but disturbed placental gas exchange upon returning to normoxemia. Umbilical artery vascular impedance did not reflect alterations in placental hemodynamics.
•Sildenafil decreased fetal blood pressure and placental blood flow in hypoxemia.•Nifedipine did not disturb placental blood flow in fetal hypoxemia.•Umbilical artery vascular impedance did not reflect placental hemodynamic changes.</description><identifier>ISSN: 0143-4004</identifier><identifier>ISSN: 1532-3102</identifier><identifier>EISSN: 1532-3102</identifier><identifier>DOI: 10.1016/j.placenta.2019.12.014</identifier><identifier>PMID: 32056540</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Animals ; Blood flow ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Female ; Fetus ; Hemodynamics - drug effects ; Hemodynamics - physiology ; Hypoxia - physiopathology ; Medicin och hälsovetenskap ; Nifedipine - pharmacology ; Physiology ; Placenta - blood supply ; Placenta - physiopathology ; Pregnancy ; Sheep ; Sildenafil Citrate - pharmacology ; Ultrasound ; Umbilical Arteries - physiopathology ; Vasodilator Agents - pharmacology</subject><ispartof>Placenta (Eastbourne), 2020-01, Vol.90, p.103-108</ispartof><rights>2019 Elsevier Ltd</rights><rights>Copyright © 2019 Elsevier Ltd. All rights reserved.</rights><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-99e2f66722ee5b342de8f421890d331ee6539ffa2a5bc4c79eab0b38417300eb3</citedby><cites>FETCH-LOGICAL-c528t-99e2f66722ee5b342de8f421890d331ee6539ffa2a5bc4c79eab0b38417300eb3</cites><orcidid>0000-0002-3039-3584 ; 0000-0002-1997-3107 ; 0000-0003-2393-7501</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.placenta.2019.12.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,552,780,784,885,3550,26567,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32056540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:142907365$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Alanne, Leena</creatorcontrib><creatorcontrib>Bhide, Amarnath</creatorcontrib><creatorcontrib>Hoffren, Jonna</creatorcontrib><creatorcontrib>Lantto, Juulia</creatorcontrib><creatorcontrib>Huhta, Heikki</creatorcontrib><creatorcontrib>Kokki, Merja</creatorcontrib><creatorcontrib>Haapsamo, Mervi</creatorcontrib><creatorcontrib>Acharya, Ganesh</creatorcontrib><creatorcontrib>Räsänen, Juha</creatorcontrib><title>Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model</title><title>Placenta (Eastbourne)</title><addtitle>Placenta</addtitle><description>We hypothesized that nifedipine and sildenafil would have no detrimental effects on placental hemodynamics and gas exchange under fetal hypoxemia.
In 33 chronically instrumented fetal sheep, placental volume blood flow (QPlac) and umbilical artery (UA) vascular impedance were measured by Doppler ultrasonography. Fetal carotid artery blood pressure and blood gas values were monitored. After baseline data collection, maternal and fetal hypoxemia were induced. Following hypoxemia phase data collection, 12 fetuses received sildenafil and 9 fetuses nifedipine infusion, and 12 fetuses served as controls receiving saline infusion. Data were collected 30 and 120 min after infusion was started. Then maternal oxygenation was normalized and normoxemia phase data were collected, while infusion was continued.
Hypoxemia significantly decreased fetal pO2 and blood pressure. In the sildenafil group at 30- and 120-min hypoxemia + infusion phases, fetal blood pressure and QPlac were significantly lower and pCO2 higher than at baseline without returning to baseline level at normoxemia + infusion phase. In hypoxemia, nifedipine did not affect fetal blood pressure or placental hemodynamics. Both in the sildenafil and nifedipine groups, fetal pO2 remained significantly lower at normoxemia + infusion phase than in the control group. Umbilical artery vascular impedance did not change during the experiment.
In fetal hypoxemia, sildenafil had detrimental effects on placental hemodynamics that disturbed placental gas exchange. Nifedipine did not alter placental hemodynamics in hypoxemia but disturbed placental gas exchange upon returning to normoxemia. Umbilical artery vascular impedance did not reflect alterations in placental hemodynamics.
•Sildenafil decreased fetal blood pressure and placental blood flow in hypoxemia.•Nifedipine did not disturb placental blood flow in fetal hypoxemia.•Umbilical artery vascular impedance did not reflect placental hemodynamic changes.</description><subject>Animals</subject><subject>Blood flow</subject><subject>Blood Pressure - drug effects</subject><subject>Blood Pressure - physiology</subject><subject>Female</subject><subject>Fetus</subject><subject>Hemodynamics - drug effects</subject><subject>Hemodynamics - physiology</subject><subject>Hypoxia - physiopathology</subject><subject>Medicin och hälsovetenskap</subject><subject>Nifedipine - pharmacology</subject><subject>Physiology</subject><subject>Placenta - blood supply</subject><subject>Placenta - physiopathology</subject><subject>Pregnancy</subject><subject>Sheep</subject><subject>Sildenafil Citrate - pharmacology</subject><subject>Ultrasound</subject><subject>Umbilical Arteries - physiopathology</subject><subject>Vasodilator Agents - pharmacology</subject><issn>0143-4004</issn><issn>1532-3102</issn><issn>1532-3102</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>3HK</sourceid><sourceid>D8T</sourceid><recordid>eNqFkkuP0zAUhS0EYkrhLwxeskm4fiSpd6DR8JBGYgNry3GuW5fEDnEC0xV_HXfaDivEypb1nXOvfA4h1wxKBqx-uy_H3lgMsyk5MFUyXgKTT8iKVYIXggF_Slb5RRQSQF6RFyntAUBJxp-TK8GhqisJK_L71jm0c6LR0eAddn70AakJHU2-7zAY53saA72M6-kOh9gdghm8TQ_g1iSK93ZnwhZpt0w-bKnDB_QwxnscvKE-UEPtborBW5p2iCPNLti_JM-c6RO-Op9r8u3D7debT8Xdl4-fb97fFbbim7lQCrmr64ZzxKoVkne4cZKzjYJOCIZYV0I5Z7ipWitto9C00IqNZI0AwFasSXHyTb9wXFo9Tn4w00FH4_X56Xu-oZaNkA3PvPonP06x-yu6CJnkChqRF1mT1yetnXyafdAhTkYzANFoAYqLTLw5Ednqx4Jp1oNPFvveBIxL0lxUlZJVDjqj9cUspjShe1yFgT5WQe_1JRt9rIJmXB-DX5Pr84ylHbB7lF2yz8C7E4D53396nHSyHoPNHZhyJXQX_f9m_AFo4sno</recordid><startdate>20200115</startdate><enddate>20200115</enddate><creator>Alanne, Leena</creator><creator>Bhide, Amarnath</creator><creator>Hoffren, Jonna</creator><creator>Lantto, Juulia</creator><creator>Huhta, Heikki</creator><creator>Kokki, Merja</creator><creator>Haapsamo, Mervi</creator><creator>Acharya, Ganesh</creator><creator>Räsänen, Juha</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>3HK</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-3039-3584</orcidid><orcidid>https://orcid.org/0000-0002-1997-3107</orcidid><orcidid>https://orcid.org/0000-0003-2393-7501</orcidid></search><sort><creationdate>20200115</creationdate><title>Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model</title><author>Alanne, Leena ; Bhide, Amarnath ; Hoffren, Jonna ; Lantto, Juulia ; Huhta, Heikki ; Kokki, Merja ; Haapsamo, Mervi ; Acharya, Ganesh ; Räsänen, Juha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-99e2f66722ee5b342de8f421890d331ee6539ffa2a5bc4c79eab0b38417300eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Animals</topic><topic>Blood flow</topic><topic>Blood Pressure - drug effects</topic><topic>Blood Pressure - physiology</topic><topic>Female</topic><topic>Fetus</topic><topic>Hemodynamics - drug effects</topic><topic>Hemodynamics - physiology</topic><topic>Hypoxia - physiopathology</topic><topic>Medicin och hälsovetenskap</topic><topic>Nifedipine - pharmacology</topic><topic>Physiology</topic><topic>Placenta - blood supply</topic><topic>Placenta - physiopathology</topic><topic>Pregnancy</topic><topic>Sheep</topic><topic>Sildenafil Citrate - pharmacology</topic><topic>Ultrasound</topic><topic>Umbilical Arteries - physiopathology</topic><topic>Vasodilator Agents - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alanne, Leena</creatorcontrib><creatorcontrib>Bhide, Amarnath</creatorcontrib><creatorcontrib>Hoffren, Jonna</creatorcontrib><creatorcontrib>Lantto, Juulia</creatorcontrib><creatorcontrib>Huhta, Heikki</creatorcontrib><creatorcontrib>Kokki, Merja</creatorcontrib><creatorcontrib>Haapsamo, Mervi</creatorcontrib><creatorcontrib>Acharya, Ganesh</creatorcontrib><creatorcontrib>Räsänen, Juha</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Placenta (Eastbourne)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alanne, Leena</au><au>Bhide, Amarnath</au><au>Hoffren, Jonna</au><au>Lantto, Juulia</au><au>Huhta, Heikki</au><au>Kokki, Merja</au><au>Haapsamo, Mervi</au><au>Acharya, Ganesh</au><au>Räsänen, Juha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model</atitle><jtitle>Placenta (Eastbourne)</jtitle><addtitle>Placenta</addtitle><date>2020-01-15</date><risdate>2020</risdate><volume>90</volume><spage>103</spage><epage>108</epage><pages>103-108</pages><issn>0143-4004</issn><issn>1532-3102</issn><eissn>1532-3102</eissn><abstract>We hypothesized that nifedipine and sildenafil would have no detrimental effects on placental hemodynamics and gas exchange under fetal hypoxemia.
In 33 chronically instrumented fetal sheep, placental volume blood flow (QPlac) and umbilical artery (UA) vascular impedance were measured by Doppler ultrasonography. Fetal carotid artery blood pressure and blood gas values were monitored. After baseline data collection, maternal and fetal hypoxemia were induced. Following hypoxemia phase data collection, 12 fetuses received sildenafil and 9 fetuses nifedipine infusion, and 12 fetuses served as controls receiving saline infusion. Data were collected 30 and 120 min after infusion was started. Then maternal oxygenation was normalized and normoxemia phase data were collected, while infusion was continued.
Hypoxemia significantly decreased fetal pO2 and blood pressure. In the sildenafil group at 30- and 120-min hypoxemia + infusion phases, fetal blood pressure and QPlac were significantly lower and pCO2 higher than at baseline without returning to baseline level at normoxemia + infusion phase. In hypoxemia, nifedipine did not affect fetal blood pressure or placental hemodynamics. Both in the sildenafil and nifedipine groups, fetal pO2 remained significantly lower at normoxemia + infusion phase than in the control group. Umbilical artery vascular impedance did not change during the experiment.
In fetal hypoxemia, sildenafil had detrimental effects on placental hemodynamics that disturbed placental gas exchange. Nifedipine did not alter placental hemodynamics in hypoxemia but disturbed placental gas exchange upon returning to normoxemia. Umbilical artery vascular impedance did not reflect alterations in placental hemodynamics.
•Sildenafil decreased fetal blood pressure and placental blood flow in hypoxemia.•Nifedipine did not disturb placental blood flow in fetal hypoxemia.•Umbilical artery vascular impedance did not reflect placental hemodynamic changes.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32056540</pmid><doi>10.1016/j.placenta.2019.12.014</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-3039-3584</orcidid><orcidid>https://orcid.org/0000-0002-1997-3107</orcidid><orcidid>https://orcid.org/0000-0003-2393-7501</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Placenta (Eastbourne), 2020-01, Vol.90, p.103-108 |
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| source | MEDLINE; NORA - Norwegian Open Research Archives; Elsevier ScienceDirect Journals Complete; SWEPUB Freely available online |
| subjects | Animals Blood flow Blood Pressure - drug effects Blood Pressure - physiology Female Fetus Hemodynamics - drug effects Hemodynamics - physiology Hypoxia - physiopathology Medicin och hälsovetenskap Nifedipine - pharmacology Physiology Placenta - blood supply Placenta - physiopathology Pregnancy Sheep Sildenafil Citrate - pharmacology Ultrasound Umbilical Arteries - physiopathology Vasodilator Agents - pharmacology |
| title | Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model |
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