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dc.contributor.authorAlanne, Leena
dc.contributor.authorBhide, Amarnath Govind
dc.contributor.authorLantto, Juulia
dc.contributor.authorHuhta, Heikki
dc.contributor.authorKokki, Merja
dc.contributor.authorHaapsamo, Mervi
dc.contributor.authorAcharya, Ganesh
dc.contributor.authorRasanen, Juha
dc.date.accessioned2021-12-07T12:20:32Z
dc.date.available2021-12-07T12:20:32Z
dc.date.issued2021-11
dc.description.abstractBackground: Nifedipine is a widely used drug in pregnancies complicated by maternal hypertensive disorders that can be associated with placental insufficiency and fetal hypoxemia. The evidence regarding fetal myocardial responses to nifedipine in hypoxemia is limited.<p> <p>Objective: We hypothesized that nifedipine would not impair fetal sheep cardiac function under hypoxemic environment. In particular, we investigated the effects of nifedipine on fetal ventricular functional parameters and cardiac output.<p> <p>Study design: A total of 21 chronically instrumented fetal sheep at 122 to 134 gestational days (term, 145 days) were included in this study. Fetal cardiac function was evaluated by measuring global longitudinal strain, indices describing ventricular systolic and diastolic function, and cardiac outputs using two-dimensional speckle tracking and tissue and spectral pulsed-wave Doppler echocardiography. Fetal carotid artery blood pressure and blood gas values were invasively monitored. After baseline data collection, fetal hypoxemia was induced by maternal hyperoxygenation. After hypoxemia phase data collection, 9 fetuses received nifedipine infusion, and 12 fetuses received saline infusion. Data were collected 30 and 120 minutes after the infusion was started. After 120 minutes of data collection, maternal and fetal oxygenation were normalized, and normoxemia phase data were collected, while infusion was continued.<p> <p>Results: Hypoxemia decreased fetal carotid artery mean arterial pressure from 40 (8) mm Hg to 35 (8) mm Hg (P<.007), and left ventricular global longitudinal strain showed less deformation than at baseline (P¼.001). Under hypoxemia, nifedipine caused a reduction in right ventricular global longitudinal strain (P<.05), a decrease in right ventricular isovolumic relaxation velocity and its deceleration (P<.01) indicating diastolic dysfunction, and a drop in right ventricular cardiac output (P<.05). Nifedipine did not alter fetal left ventricular functional parameters or cardiac output. When normoxemia was restored, fetal right ventricular functional parameters and cardiac output returned to baseline level.<p> <p>Conclusion: In hypoxemic fetus, nifedipine impaired right ventricular function and reduced its cardiac output. The detrimental effects of nifedipine on fetal right ventricular function were abolished, when normoxemia was restored. Our findings suggest that in a hypoxemic environment nifedipine triggers detrimental effects on fetal right ventricular function.en_US
dc.identifier.citationAlanne, Bhide AG, Lantto, Huhta, Kokki, Haapsamo, Acharya, Rasanen. Nifedipine disturbs fetal cardiac function during hypoxemia in a chronic sheep model at near term gestation. American Journal of Obstetrics and Gynecology. 2021:1-9en_US
dc.identifier.cristinIDFRIDAID 1921024
dc.identifier.doi10.1016/j.ajog.2021.04.228
dc.identifier.issn0002-9378
dc.identifier.issn1097-6868
dc.identifier.urihttps://hdl.handle.net/10037/23306
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalAmerican Journal of Obstetrics and Gynecology
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756en_US
dc.titleNifedipine disturbs fetal cardiac function during hypoxemia in a chronic sheep model at near term gestationen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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