The fetoplacental pressor effects of low-dose acetylsalicylic acid and angiotensin II in the ex vivo cotyledon model

Abstract

Objective: Our purpose was to investigate perfusion pressure changes ex vivo induced by angiotensin II on fetoplacental vasculature pretreated with low-dose acetylsalicylic acid. Study Design: Two cotyledons from each of 12 placentas were perfused. The intervillous space of one cotyledon was infused with acetylsalicylic acid (5 × 10 –5 mol/L) similar to the serum concentration of women receiving daily low-dose aspirin therapy (60 to 81 mg). The control cotyledon was infused with an equivalent amount of normal saline solution. Two doses of angiotensin II, 1 × 10 –11.5 and 1 × 10 –10 moles, were injected as boluses into the chorionic arteries of each cotyledon. A 3 × 10 –7 mole dose of angiotensin II was also injected into the intervillous space. Statistical analysis was performed with analysis of variance, and results are expressed as mean pressure change in millimeters of mercury ± SEM. Results: Perfusion pressure response did not vary between cotyledons pretreated with acetylsalicylic acid and control cotyledons when 3 × 10 –7 moles of angiotensin II was injected into the intervillous space (8.0 ± 1.9 mm Hg vs 9.8 ± 1.6 mm Hg, p = 0.59). There were no differences between cotyledons in pressure response to 1 × 10 –11.5 moles of angiotensin II injected into the fetal circuit (5.9 ± 0.8 mm Hg vs 6.7 ± 0.9 mm Hg, p = 0.51). However, in the cotyledons pretreated with acetylsalicylic acid there was a decrease in the pressor response to 1 × 10 –10 moles of angiotensin II (14.1 ± 1.4 mm Hg vs 21.5 ± 3.3 mm Hg, p = 0.05). Conclusions: Low-dose aspirin infused into the intervillous space decreases vasoconstriction elicited by angiotensin II in the fetoplacental compartment. This suggests that maternal low-dose aspirin therapy has effects in the fetoplacental circulation in addition to its effects in the maternal circulation.