University of Oulu

Leena Alanne, Amarnath Bhide, Jonna Hoffren, Juulia Lantto, Heikki Huhta, Merja Kokki, Mervi Haapsamo, Ganesh Acharya, Juha Räsänen, Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model, Placenta, Volume 90, 2020, Pages 103-108, ISSN 0143-4004, https://doi.org/10.1016/j.placenta.2019.12.014

Effects of nifedipine and sildenafil on placental hemodynamics and gas exchange during fetal hypoxemia in a chronic sheep model

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Author: Alanne, Leena1; Bhide, Amarnath2,3; Hoffren, Jonna1;
Organizations: 1Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
2Department of Obstetrics and Gynecology, St. George's Hospital, London, United Kingdom
3Women's Health & Perinatal Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
4Department of Obstetrics and Gynecology, Oulu University Hospital and University of Oulu, Oulu, Finland
5Department of Surgery, Oulu University Hospital, Oulu, Finland
6Department of Anesthesiology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
7Department of Obstetrics and Gynecology, Satakunta Central Hospital, Pori, Finland
8Department of Clinical Science, Intervention & Technology, Karolinska Institute and Center for Fetal Medicine Karolinska University Hospital, Stockholm, Sweden
9Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2020040310235
Language: English
Published: Elsevier, 2020
Publish Date: 2020-12-16
Description:

Abstract

Introduction: We hypothesized that nifedipine and sildenafil would have no detrimental effects on placental hemodynamics and gas exchange under fetal hypoxemia.

Methods: 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.

Results: 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.

Discussion: 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.

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Series: Placenta
ISSN: 0143-4004
ISSN-E: 1532-3102
ISSN-L: 0143-4004
Volume: 90
DOI: 10.1016/j.placenta.2019.12.014
OADOI: https://oadoi.org/10.1016/j.placenta.2019.12.014
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3111 Biomedicine
Subjects:
Funding: This work was supported by the regional authority of Northern Norway (project no 12050).
Copyright information: © 2019 Elsevier Ltd. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.
  https://creativecommons.org/licenses/by-nc-nd/4.0/