Placental transfer and vascular effects of pharmaceutical drugs in the human placenta ex vivo: A review

Hove, Hedwig van; Mathiesen, Line; Freriksen, Jolien J. M.; Vähäkangas, Kirsi; Colbers, Angela; Brownbill, Paul; Greupink, Rick

doi:10.1016/j.placenta.2022.03.128

Cited by 5 publications

(4 citation statements)

References 180 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dual-side ex vivo placenta perfusion is the gold standard technique to study placental drug disposition. Generally, the technique provides a good match between ex vivo and in vivo observations ( van Hove, 2022 ). It should be noted that in specific cases, mismatch between ex vivo and in vivo observations occurs.…”

Section: Discussionmentioning

confidence: 99%

“…In the intervillous space at the maternal site of the cotyledon 4 cannulas were inserted establishing a maternal circulation of 12 mL/min. These flows are within the range commonly used within the field and considered physiological ( van Hove, 2022 ). After a pre-perfusion period of 30–45 min, in which the system was stabilized and remaining blood was flushed out of the cotyledon, the pre-perfusion buffers were switched for clean experimental buffers and both the maternal and fetal circuit were closed to achieve recirculation.…”

Section: Methodsmentioning

confidence: 99%

“…This includes recommendations on the use of quality criteria for successful perfusions ( Schneider, 2022 ). While such criteria and corresponding cut-off values are not harmonized yet, most groups include loss of fluid from the fetal circulation, and maternal-to-fetal transfer of the small molecule antipyrine ( van Hove, 2022 ). Fluid loss helps to evaluate integrity of the cotyledon as such and antipyrine transfer is used to evaluate if there is overlap of fetal and maternal circulations (i.e.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Placental transfer of tofacitinib in the ex vivo dual-side human placenta perfusion model

Eliesen,

Fransen,

van Hove

et al. 2024

Current Research in Toxicology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Placental transfer of tofacitinib in the ex vivo dual-side human placenta perfusion model

Eliesen,

Fransen,

van Hove

et al. 2024

Current Research in Toxicology

View full text Add to dashboard Cite

“…Most drugs given to pregnant women may affect the fetus after they are transferred across the placenta and enter the systemic circulation of the fetus. The effects of the transferred drug on the fetus depend on the type of drug and the general fetal conditions ( Bouazza et al, 2019 ; Kolding, Eken & Uldbjerg, 2020 ; van Hove et al, 2022 ). Therefore, it is essential to understand the pharmacology of local anesthetic, the most commonly used drugs in dental treatment, for safe and effective dental treatment during pregnancy ( Ouanounou & Haas, 2016 ).…”

Section: Survey Methodologymentioning

confidence: 99%

Physiology of pregnancy and oral local anesthesia considerations

Zhou

Zhong

Pan

et al. 2023

PeerJ

View full text Add to dashboard Cite

Background Safe and effective local anesthesia is a prerequisite for emergency oral surgeries and most dental treatments. Pregnancy is characterized by complex physiological changes, and increased sensitivity to pain. Pregnant women are particularly vulnerable to oral diseases, such as caries, gingivitis, pyogenic granuloma and third molar pericoronitis. Maternally administered drugs can affect the fetus through the placenta. Therefore, many physicians and patients are reluctant to provide or accept necessary local anesthesia, which leads to delays in the condition and adverse consequences. This review is intended to comprehensively discuss the instructions for local anesthesia in the oral treatment of pregnant patients. Methodology An in-depth search on Medline, Embase, and the Cochrane Library was performed to review articles concerned with maternal and fetal physiology, local anesthetic pharmacology, and their applications for oral treatment. Results Standard oral local anesthesia is safe throughout the pregnancy. At present, 2% lidocaine with 1:200,000 epinephrine is considered to be the anesthetic agent that best balances safety and efficacy for pregnant women. Maternal and fetal considerations must be taken into account to accommodate the physiological and pharmacological changes in the gestation period. Semi-supine position, blood pressure monitoring, and reassurance are suggested for high-risk mothers to reduce the risk of transient changes in blood pressure, hypoxemia, and hypoglycemia. For patients with underlying diseases, such as eclampsia, hypertension, hypotension, and gestational diabetes, the physicians should use epinephrine cautiously and control the dose of anesthetic. New local anesthesia formulations and equipment, which contribute to minimizing injection pain and relieving the anxiety, have and are being developed but remain understudied. Conclusions Understanding the physiological and pharmacological changes during pregnancy is essential to ensure the safety and efficiency of local anesthesia. Optimal outcomes for the mother and fetus hinge on a robust understanding of the physiologic alterations and the appropriate selection of anesthetic drugs and approaches.

show abstract

The impact of opioids on the transcriptional landscape of human villous trophoblasts

Sadovsky,

Chu,

Barak

et al. 2023

Placenta

View full text Add to dashboard Cite

Placental transfer and vascular effects of pharmaceutical drugs in the human placenta ex vivo: A review

Cited by 5 publications

References 180 publications

Placental transfer of tofacitinib in the ex vivo dual-side human placenta perfusion model

Placental transfer of tofacitinib in the ex vivo dual-side human placenta perfusion model

Physiology of pregnancy and oral local anesthesia considerations

The impact of opioids on the transcriptional landscape of human villous trophoblasts

Contact Info

Product

Resources

About