Cardiovascular and hematologic effects of diphenylhydantoin in maternal and fetal sheep. 1981

J Ayromlooi, and D M Desiderio, and M Tobias

Anticonvulsant therapy often includes diphenylhydantoin (Dilantin) and is usually advocated during the pregnancy of an epileptic woman. The cardiovascular and hematologic effects of diphenylhydantoin (5 mg/kg body weight/5 min) were studied in 12 experiments on 5 ewes and their fetuses in which catheters were chronically implanted and an electromagnetic flow probe was continually around the uterine artery. Slight but significant transient decreases in fetal blood pressure (P less than .001), oxygen percent saturation (O2%, P less than .02) and O2 content (P less than .01) were observed. These parameters recovered to baseline values within 75 minutes after infusion was begun, and no other fetal changes were noted. Maternal metabolic alkalosis was evidenced by significant increases in pH (P less than .001) bicarbonate (P less than .05), and base excess (P less than .02). A slight decrease in the percent hemoglobin was observed at 15, 60, and 90 minutes (P less than .02, P less than .05, and P less than .01, respectively). No changes were observed in maternal heart rate or uterine blood flow, though an increase in blood pressure was observed at 30 minutes (P less than .05). From these observations, it is concluded that the administration of diphenylhydantoin intravenously causes transient fetal hypotension, reduction of O2%, maternal metabolic alkalosis, and transient hypertension without any changes in fetal pH, PCO2, or uterine blood flow. Therefore, it can be considered a relatively safe drug to be used during pregnancy.

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
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010672 Phenytoin An anticonvulsant that is used to treat a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. Diphenylhydantoin,Fenitoin,Phenhydan,5,5-Diphenylhydantoin,5,5-diphenylimidazolidine-2,4-dione,Antisacer,Difenin,Dihydan,Dilantin,Epamin,Epanutin,Hydantol,Phenytoin Sodium,Sodium Diphenylhydantoinate,Diphenylhydantoinate, Sodium
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
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002319 Cardiovascular System The HEART and the BLOOD VESSELS by which BLOOD is pumped and circulated through the body. Circulatory System,Cardiovascular Systems,Circulatory Systems
D004827 Epilepsy A disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns (e.g., nocturnal epilepsy). (From Adams et al., Principles of Neurology, 6th ed, p313) Aura,Awakening Epilepsy,Seizure Disorder,Epilepsy, Cryptogenic,Auras,Cryptogenic Epilepsies,Cryptogenic Epilepsy,Epilepsies,Epilepsies, Cryptogenic,Epilepsy, Awakening,Seizure Disorders
D005260 Female Females
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse

Related Publications

J Ayromlooi, and D M Desiderio, and M Tobias
February 1983, American journal of obstetrics and gynecology,
J Ayromlooi, and D M Desiderio, and M Tobias
January 1988, Anesthesiology,
J Ayromlooi, and D M Desiderio, and M Tobias
April 1984, American journal of obstetrics and gynecology,
J Ayromlooi, and D M Desiderio, and M Tobias
April 1982, American journal of obstetrics and gynecology,
J Ayromlooi, and D M Desiderio, and M Tobias
October 1993, American journal of obstetrics and gynecology,
J Ayromlooi, and D M Desiderio, and M Tobias
February 2005, BJOG : an international journal of obstetrics and gynaecology,
J Ayromlooi, and D M Desiderio, and M Tobias
May 1982, American journal of obstetrics and gynecology,
J Ayromlooi, and D M Desiderio, and M Tobias
March 1997, American journal of obstetrics and gynecology,
J Ayromlooi, and D M Desiderio, and M Tobias
December 2003, Journal of the Society for Gynecologic Investigation,
J Ayromlooi, and D M Desiderio, and M Tobias
April 1962, The American journal of physiology,
Copied contents to your clipboard!