Ritodrine infusion during late pregnancy: Effects on fetal and placental blood flow, prostacyclin, and thromboxane

Abstract

To study the effects of ritodrine on fetal and placental blood flow and maternal prostacyclin and thromboxane A2, 14 women with premature uterine contractions between the thirty-first and thirty-sixth weeks of pregnancy were treated with intravenous infusions of ritodrine, with incremental doses up to 200 μg per minute. The intervillous and the umbilical vein blood flows were measured before and after 1 hour of infusion of ritodrine, with the xenon 133 method and with a combination of real-time and Doppler ultrasonic equipment, respectively. Ritodrine decreased maternal diastolic and mean arterial pressures, as well as placental vascular resistance, but caused no significant changes in intervillous and umbilical vein blood flows. Ritodrine stimulated the synthesis of vasodilatory prostacyclin, as seen from a rise in maternal plasma 6-keto-prostaglandin F1α, but inhibited the platelets' capacity to generate the vasoconstrictor thromboxane A2. Thus, apart from maternal hemodynamic changes, the intervillous and umbilical circulations are maintained during short-term administration of ritodrine in normotensive pregnancies.