VASOACTIVE DRUGS IN OBSTETRICS - A REVIEW OF DATA OBTAINED BY DOPPLERAND COLOR DOPPLER METHODS

Objective: We did a literature review of the hemodynamic effects of di fferent vasoactive agents, as assessed by Doppler and color Doppler me thods. Methods: The review included reports dealing with the Doppler m ethod assisted by basic ultrasound real-time, M-mode, and color Dopple r techniques. Results and Conclusions: Maternal vasoactive drugs (labe talol, dihydralazine, pindolol, nifedipine), anesthesia, and maternal position do not hinder the uteroplacental and fetal circulation to the extent that clinical complications would ensue. However, if these fac tors are strong enough, an increased vascular resistance in the uterin e arteries does appear without any immediate compromises in fetal hemo dynamics. Some regulatory changes do occur, however, in the fetal cere bral and renal arteries and in fetal myocardial contractility. This si gnifies that some vasoactive drugs may compromise fetal hemodynamics, especially in fetuses with poor blood or oxygen supply before treatmen t. One good example of the fetal hemodynamic changes caused by materna l drug is the vasoconstriction of fetal ductus arteriosus during mater nal intake of indomethacin, and demonstrated by the Doppler technique. The circulatory safety of both routinely used vasoactive agents and n ew drugs can now be tested with the Doppler method more reliably than before. Increased understanding of uterine and fetal hemoodynmic regul ation in many different clinical conditions and their treatment schedu les has benefited perinatal practice.