Perfusion studies of glyburide transfer across the human placenta: Implications for fetal safety

摘要: Objective Gestational diabetes affects up to 5% of women. Oral hypoglycemics have been avoided because the assumption that their placental transfer may cause fetal-neonatal hypoglycemia. A recent randomized trial could not show measurable glyburide levels in umbilical blood despite maternal treatment with regular doses glyburide. The mechanism underlying this phenomenon is known. objective our study was document, using a human placenta perfusion model, whether actively effluxed from fetal circulation. Study design In vitro studies cotyledon were performed quantify Using close circle experiments and introducing both circulations at 200 ng/mL, we looked for evidence transport against concentration gradient fetus mother. parallel experiments, P-glycoprotein inhibitor verapamil used an attempt inhibit transplacental movement. Results There highly significant Fetal-to-maternal ratio 0.92 ± 0.23 start experimental period 0.31 0.47 3 hours later ( P = .01) (n 5). Verapamil did modify transport. Conclusion This first direct active mother and, general, any medicinal drug during pregnancy. These suggest efflux by transporter other than P-glycoprotein. Alternatively, it possible minority carried P-glycoprotein, but most load pumped yet-unidentified system.