Prolonged morphine exposure <b><i>in utero</i></b> causes fetal and placental vasoconstriction: A case report

Collins, Laura R; Hall, Richard; Dajani, Nafisa K.; Wendel, Paul J.; Lowery, Curtis L.; Kay, Helen H.

doi:10.1080/14767050500123996

Cited by 21 publications

(13 citation statements)

References 6 publications

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“…Since prolonged intrauterine morphine exposure may cause fetal and placental vasoconstriction (Collins et al 2005), it seems that detrimental effects of morphine are partly due to provoked oxidative stress in placental tissue. It has been demonstrated that hypoxia can stimulate apoptosis in placental tissues, and increased level of placental apoptosis may lead to fetal growth restriction (Chen and Dai 2008;Gude et al 2000;Myatt and Cui 2004).…”

Section: Discussionmentioning

confidence: 99%

Maternal Oral Consumption of Morphine Increases Bax/Bcl-2 Ratio and Caspase 3 Activity During Early Neural System Development in Rat Embryos

et al. 2009

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Maternal morphine consumption has been shown to result in physical and neurobehavioral defects in fetus and offspring, but the underlying molecular mechanisms of these defects remain unclear. Regarding the critical role of apoptosis in normal development of central nervous system, the present study was designed to investigate the effect of intrauterine morphine exposure on programmed cell death of neuroblasts during the early development of neural system. Pregnant Wistar rats received morphine sulfate through drinking water at the concentration of 0.01 mg/ml (20 ml water per day for each rat) from the first day of gestation to the time of sampling. Control groups received tap water. Control and morphine-treated pregnant rats, each in five separated groups, were killed on gestational days 9.5 to 13.5, and the embryos were taken out, fixed, and embedded in paraffin. Immunohistochemical assay was used to reveal the protein expression of Bax, Bcl2, and the activation of caspase 3. The results showed a significant increase in Bax immunoreactivity in all of the mentioned embryonic days (E9.5 to E13.5) and a significant decrease in Bcl-2 immunoreactivity at days E10.5 and E12.5 in morphine-treated groups compared with control. Data analysis revealed that Bax/Bcl2 ratio was increased in all of the morphine-exposed groups. Consistent with these results, immunostaining of cleaved caspase 3 showed a significant increase at days E11.5 to E13.5. These findings suggest that morphine exposure during the first embryonic days may enhance the susceptibility of neuroblasts to apoptosis by upregulating the ratio of Bax to Bcl-2 protein expression and increasing downstream caspase-3 activity. The increased probability of neuroblast apoptosis may be the cause of morphine-induced defects in the central nervous system development and its structural and neurobehavioral consequences.

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Section: Discussionmentioning

confidence: 99%

Maternal Oral Consumption of Morphine Increases Bax/Bcl-2 Ratio and Caspase 3 Activity During Early Neural System Development in Rat Embryos

et al. 2009

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“…Today, it is known that the embryo is more sensitive to exogenous substances (such as drugs) in certain periods of pregnancy [4]. According to scientists' studies, morphine acts as a mitogenic stimulus.…”

Section: Discussionmentioning

confidence: 99%

“…According to some research, these symptoms may be due to a delay in the differentiation of the nervous system [2]. Also, since the placenta plays an essential role in fetal development, any kind of placental dysfunction leads to abnormalities in the growth and development of the embryo [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

Time-Dependent Effect of Oral Morphine Consumption on the Development of Cytotrophoblast and Syncytiotrophoblast Cells of the Placental Layers during the Three Different Periods of Pregnancy in Wistar Rats

Dehghani

Sahraei

Meamar

et al. 2013

Clinical and Developmental Immunology

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Previous studies have shown that morphine abuse during pregnancy cancause a delay in the development of the placenta and embryo and also bring about birth defects. The present study investigates the effect of the duration of maternal morphine consumption during pregnancy, as well as the impacts of morphine abuse on the development of placental layers during the three different periods of pregnancy in Wistar rats. Materials and Methodology. Female Wistar rats have been used in the present study. Experimental groups received morphine (0.05 mg/mL of drinking water) after one night of coupling with male rats for mating. On 9th, 10th, and 14th days of pregnancy, pregnant animals were killed, and placentas were removed and fixed. The cells of the placentas layers were calculated by light microscope and MOTIC and SPSS software. Results. The maternal surface thickness of the placenta was significantly increased, whereasthe fetal surface thickness of placenta was significantly decreased with morphine consumption with a time-dependent manner in experimental groups, compared to control groups. Moreover, the number of trophoblast cells increased in both maternal and fetal surfaces of placenta with respect to the duration of morphine consumption which was overt in the experimental groups compared to the control groups. Conclusion. In general, the time-dependent effects of oral morphine consumption can inhibit the development and natural functioning of cytotrophoblast and syncytiotrophoblast cells of the placental layers.

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“…Opioids should never be discontinued abruptly because the ensuing withdrawal syndrome may produce uterine irritation, miscarriage or premature delivery [18]. Whenever opioid infusions are required, the suggestion is to use opioids with minimal active metabolites [19].…”

Section: Discussionmentioning

confidence: 99%

Pain Management in a Parturient with Presacral Mass

Ru¹,

Lew²,

Yian³

et al. 2017

OJAnes

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Presacral masses are rare lesions and due to obscure anatomic location and etiological heterogeneity, they pose a diagnostic and therapeutic challenge. Literature is limited on the pain management of a parturient with presacral mass. We describe here a parturient in her second trimester with severe pain from a presacral mass. A high clinical acumen with early multidisciplinary involvement are needed to establish a diagnosis and provide treatment options for the well-being of the patient, minimize fetal teratogenicity, avoid chronic symptoms and long-term disability.

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Prolonged morphine exposure in utero causes fetal and placental vasoconstriction: A case report

Cited by 21 publications

References 6 publications

Maternal Oral Consumption of Morphine Increases Bax/Bcl-2 Ratio and Caspase 3 Activity During Early Neural System Development in Rat Embryos

Maternal Oral Consumption of Morphine Increases Bax/Bcl-2 Ratio and Caspase 3 Activity During Early Neural System Development in Rat Embryos

Time-Dependent Effect of Oral Morphine Consumption on the Development of Cytotrophoblast and Syncytiotrophoblast Cells of the Placental Layers during the Three Different Periods of Pregnancy in Wistar Rats

Pain Management in a Parturient with Presacral Mass

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