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Placental and Fetal Hemodynamics After Labetalol or Pindolol in a Sheep Model of Increased Placental Vascular Resistance and Maternal Hypertension

Department of Anesthesiology, Oulu University Hospital, Finland, tiina.erkinaro{at}pp.fimnet.fi

Tomi Kavasmaa, MD

Department of Anesthesiology, Oulu University Hospital, Finland

Laura Ylikauma, MB

Department of Anesthesiology, Oulu University Hospital, Finland

Kaarin Mäkikallio, MD, PhD

Department of Obstetrics and Gynecology, Oulu University Hospital, Finland

Mervi Haapsamo, MD

Department of Obstetrics and Gynecology, Oulu University Hospital, Finland

Ganesh Acharya, MD, PhD

Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tromsø and University Hospital of Northern Norway, Tromsø, Norway

Pasi Ohtonen, MSc

Department of Surgery, Oulu University Hospital, Finland

Seppo Alahuhta, MD, PhD

Department of Anesthesiology, Oulu University Hospital, Finland

Juha Räsänen, MD, PhD

Department of Obstetrics and Gynecology, Oulu University Hospital, Finland

We investigated the effects of labetalol and pindolol on uterine, placental, and fetal hemodynamics following norepinephrine-induced maternal hypertension in a sheep model of increased placental vascular resistance. Also, we examined fetal and placental hemodynamic responses to acute hypoxemia after antihypertensive medication. Norepinephrine increased maternal heart rate (HR), mean arterial pressure (MAP) and uterine vascular resistance (R_UtA), and decreased uterine volume blood flow (Q_UtA). Both labetalol and pindolol decreased maternal HR, MAP, and R_UtA, but did not restore Q_UtA. Fetal MAP was unaffected while fetal HR and placental volume blood flow (Q_UA) decreased and placental vascular resistance increased. During hypoxemia, which was induced by decreasing maternal inspiratory oxygen fraction, all these parameters remained unchanged in the labetalol group while fetal HR increased and Q_UA further decreased in the pindolol group. We conclude that labetalol and pindolol may compromise uterine and placental hemodynamics. Hypoxemic stress provokes divergent hemodynamic responses in fetuses exposed to these differently acting adrenoceptor antagonists.

Key Words: Labetalol • pindolol • hypoxemia • placental circulation • fetus.

This version was published on August 1, 2009

Reproductive Sciences, Vol. 16, No. 8, 749-757 (2009)
DOI: 10.1177/1933719109335068


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