Maternally administered esmolol produces fetal beta-adrenergic blockade and hypoxemia in sheep. 1989

J C Eisenach, and M I Castro
Department of Anesthesia, Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103.

Although esmolol may be a useful therapeutic agent in obstetrics and obstetric anesthesia, concerns about fetal safety have limited its use. To assess acute fetal hemodynamic effects of maternally administered esmolol, saline or esmolol (4-200 micrograms.kg-1.min-1 in a stepped manner) was infused into maternal venous catheters in nine chronically prepared pregnant ewes, and the degree of beta-adrenergic blockade was assessed by isoproterenol challenge. In control experiments saline infusion and repeated isoproterenol challenges did not alter measured parameters, although maternally administered isoproterenol (0.1 micrograms) transiently decreased uterine blood flow by 20 +/- 5% (mean +/- SEM; P less than 0.05). Esmolol produced a dose-dependent decrease in maternal blood pressure and fetal heart rate (maternal blood pressure decreased by 22 +/- 8% and fetal heart rate decreased by 27 +/- 7% following esmolol, 200 micrograms.kg-1.min-1; P less than 0.05). Fetal arterial PO2 decreased from 18.2 +/- 1.2 mmHg before to 14.1 +/- 1.5 mmHg following esmolol, 200 micrograms.kg-1.min-1 (P less than 0.05). Maternally administered esmolol produced similar dose-dependent beta-adrenergic blockade in both ewe and fetus, with complete blockade following the 80 and 200 micrograms.kg-1.min-1 doses. Thirty minutes following cessation of esmolol infusion, fetal resting heart rate and maternal and fetal isoproterenol-stimulated heart rate remained below control values. These results suggest that maternally administered esmolol may produce adverse fetal effects, limiting its usefulness in the obstetric setting.

UI MeSH Term Description Entries
D008431 Maternal-Fetal Exchange Exchange of substances between the maternal blood and the fetal blood at the PLACENTA via PLACENTAL CIRCULATION. The placental barrier excludes microbial or viral transmission. Transplacental Exposure,Exchange, Maternal-Fetal,Exposure, Transplacental,Maternal Fetal Exchange
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011412 Propanolamines AMINO ALCOHOLS containing the propanolamine (NH2CH2CHOHCH2) group and its derivatives. Aminopropanols
D012146 Rest Freedom from activity. Rests
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D005312 Fetal Blood Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the PLACENTA. The cord blood is blood contained in the umbilical vessels (UMBILICAL CORD) at the time of delivery. Cord Blood,Umbilical Cord Blood,Blood, Cord,Blood, Fetal,Blood, Umbilical Cord,Bloods, Cord,Bloods, Fetal,Bloods, Umbilical Cord,Cord Blood, Umbilical,Cord Bloods,Cord Bloods, Umbilical,Fetal Bloods,Umbilical Cord Bloods
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D000143 Acids Chemical compounds which yield hydrogen ions or protons when dissolved in water, whose hydrogen can be replaced by metals or basic radicals, or which react with bases to form salts and water (neutralization). An extension of the term includes substances dissolved in media other than water. (Grant & Hackh's Chemical Dictionary, 5th ed) Acid
D000319 Adrenergic beta-Antagonists Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety. Adrenergic beta-Antagonist,Adrenergic beta-Receptor Blockader,Adrenergic beta-Receptor Blockaders,beta-Adrenergic Antagonist,beta-Adrenergic Blocker,beta-Adrenergic Blocking Agent,beta-Adrenergic Blocking Agents,beta-Adrenergic Receptor Blockader,beta-Adrenergic Receptor Blockaders,beta-Adrenoceptor Antagonist,beta-Blockers, Adrenergic,beta-Adrenergic Antagonists,beta-Adrenergic Blockers,beta-Adrenoceptor Antagonists,Adrenergic beta Antagonist,Adrenergic beta Antagonists,Adrenergic beta Receptor Blockader,Adrenergic beta Receptor Blockaders,Adrenergic beta-Blockers,Agent, beta-Adrenergic Blocking,Agents, beta-Adrenergic Blocking,Antagonist, beta-Adrenergic,Antagonist, beta-Adrenoceptor,Antagonists, beta-Adrenergic,Antagonists, beta-Adrenoceptor,Blockader, Adrenergic beta-Receptor,Blockader, beta-Adrenergic Receptor,Blockaders, Adrenergic beta-Receptor,Blockaders, beta-Adrenergic Receptor,Blocker, beta-Adrenergic,Blockers, beta-Adrenergic,Blocking Agent, beta-Adrenergic,Blocking Agents, beta-Adrenergic,Receptor Blockader, beta-Adrenergic,Receptor Blockaders, beta-Adrenergic,beta Adrenergic Antagonist,beta Adrenergic Antagonists,beta Adrenergic Blocker,beta Adrenergic Blockers,beta Adrenergic Blocking Agent,beta Adrenergic Blocking Agents,beta Adrenergic Receptor Blockader,beta Adrenergic Receptor Blockaders,beta Adrenoceptor Antagonist,beta Adrenoceptor Antagonists,beta Blockers, Adrenergic,beta-Antagonist, Adrenergic,beta-Antagonists, Adrenergic,beta-Receptor Blockader, Adrenergic,beta-Receptor Blockaders, Adrenergic

Related Publications

J C Eisenach, and M I Castro
December 1991, AANA journal,
J C Eisenach, and M I Castro
January 1990, Journal of clinical anesthesia,
J C Eisenach, and M I Castro
December 1997, The American journal of physiology,
J C Eisenach, and M I Castro
August 1984, Journal of developmental physiology,
J C Eisenach, and M I Castro
July 1993, Journal of applied physiology (Bethesda, Md. : 1985),
J C Eisenach, and M I Castro
August 1991, Journal of developmental physiology,
J C Eisenach, and M I Castro
January 1979, Gynecologic and obstetric investigation,
J C Eisenach, and M I Castro
April 1972, American journal of obstetrics and gynecology,
Copied contents to your clipboard!