Hemodynamic and growth effect of indomethacin on fetal goat model of intrauterine balloon aortic valvuloplasty

Abstract

Objective To investigate the fetal hemodynamic and growth effect, maternal pregnant outcome of indomethacin on pregnant goat model of intrauterine balloon aortic valvuloplasty(IUBAV). Methods Forty twin pregnant goats(106-124 gestational days, term: 150 days) were designed as the research objects and IUBAV model was established.According to whether adopting indomethacin to pregnant goat, 40 pregnant goats were randomly divided into control group(placebo to pregnant goat, n=20) and indomethacin group(feeding indomethacin to pregnant goat, n=20). According to the IUBAV and indomethacin administration, 80 fetal sheep were then enrolled into 4 groups.A1 group: maternal placebo+ fetal control, A2 group: placebo+ fetal IUBAV, B1 group: maternal indomethacin+ fetal control, B2 group: maternal indomethacin+ fetal IUBAV.Following parameters were included and statistical analysis was done among diffe-rent groups, which included fetal heart rate, biparietal diameter, aortic annulus diameter, umbilical/aortic systolic peak velocity and the end diastolic velocity ratio(S/D), the diameter of the ductus arteriosus and peak velocity and flow pattern of trans ductus blood flow, body weight and hematocrit of full-term newborn goats. Results After indomethacin adopting, the post-procedure preterm birth rate of pregnant goats was decreased from 50.00% to 8.33%.Fetal heart rate and umbilical/aortic S/D increased post-procedure, and gradually recovered to 3-day post-procedure, and there existed significant statistical differences among the groups(P 0.05) after indomethacin administration.After IUBAV, there was no significant difference among all groups in fetal biparietal diameter, aortic annular diameter, body weight and hematocrit of full-term newborn goats(P>0.05). Conclusions Indomethacin can improve post-IUBAV pregnancy outcome of pregnant ewes, provide protective inhibition effects on hemodynamic changes to fetal goats, and could avoid fetal ductus constriction, intrauterine growth retardation, which is proved to be an effective protective measure of fetal cardiac intervention. Key words: Fetal goat; Intrauterine; Balloon aortic valvuloplasty; Indomethacin; Hemodynamics