title: Transplacental transfer of cefuroxime in uncomplicated pregnancies and those complicated by hydrops or changes in amniotic fluid volume.
abstract: The transplacental transfer of cefuroxime was determined at antenatal fetal blood sampling in a cross sectional study of 78 patients between 15-35 weeks' gestation, 8-138 minutes after a maternal intravenous dose of 750 mg. Mean serum cefuroxime concentration, measured by high performance liquid chromatography, was 7.4 (95% confidence interval (CI) 6.8 to 8.1) mg/l in control fetuses; concentrations in hydropic fetuses were similar (6.2 mg/l, CI 4.7 to 7.7) but in fetuses with oligohydramnios they were significantly lower, (4.9 mg/l, CI 3.6 to 6.2). Antibiotic concentration did not correlate with gestational age and remained unchanged by transfusion of packed red cells. We conclude that (i) fetal serum concentrations of cefuroxime obtained after a maternal dose of 750 mg are only adequate for prophylaxis against organisms with a minimum inhibitory concentration of < 4 mg/l and (ii) transplacental passage of cefuroxime is significantly reduced in the presence of oligohydramnios.
authors.affiliation: Royal Postgraduate Medical School's Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London.
authors.forename: D E
authors.initials: DE
authors.lastname: Holt
authors.forename: N M
authors.initials: NM
authors.lastname: Fisk
authors.forename: J A
authors.initials: JA
authors.lastname: Spencer
authors.forename: J
authors.initials: J
authors.lastname: de Louvois
authors.forename: R
authors.initials: R
authors.lastname: Hurley
authors.forename: D
authors.initials: D
authors.lastname: Harvey
mesh_terms: D000653:Amniotic Fluid / Q000737:chemistry; D002444:Cefuroxime / Q000032:analysis / Q000493:pharmacokinetics*; D003430:Cross-Sectional Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D015160:Hydrops Fetalis / Q000378:metabolism*; D008431:Maternal-Fetal Exchange; D016104:Oligohydramnios / Q000378:metabolism*; D011247:Pregnancy / Q000378:metabolism*
chemical_list: D002444:Cefuroxime