In vitro analysis of human transplacental transport of desmopressin.
OBJECTIVE
Desmopressin (DDAVP) therapy may be required during pregnancy, but there are limited data about its safety. We wished to verify whether DDAVP is transported across the human placenta.


METHODS
Using the in vitro human placental cotyledon perfusion model, we performed serial measurements of maternal and fetal DDAVP concentrations. After introducing the drug into the maternal circulation at estimated baseline therapeutic (30 pg/ml) and supratherapeutic (16,000 and 60,000 pg/ml) concentrations, we measured the rate of transplacental drug transfer up to 2 h.


RESULTS
There was no detectable transport of DDAVP at a 30 pg/ml concentration, and the maternal drug concentration remained stable over time. At a much higher maternal concentration of 60,000 pg/ml, the mean peak fetal DDAVP concentration was 2990 pg/ml, equivalent to 4.8% of the baseline maternal concentration.


CONCLUSIONS
At a therapeutic maternal drug concentration, DDAVP does not appear to cross the placenta within detectable limits. At much higher drug concentrations, DDAVP may cross the placenta in a small amount. Future in vitro clinical studies should attempt to reproduce these findings.
Ray
Joel G
JG
Obstetrical Medicine, Department of Medicine, and Inner City Health Research Program, St. Michael's Hospital, Toronto, ON, Canada. Jray515445@aol.com
Boskovic
Rada
R
Knie
Brenda
B
Hard
Marjie
M
Portnoi
Galina
G
Koren
Gideon
G
D001692:Biological Transport; D003894:Deamino Arginine Vasopressin / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008431:Maternal-Fetal Exchange / Q000502:physiology; D015394:Molecular Structure; D010920:Placenta / Q000378:metabolism*; D011247:Pregnancy
D003894:Deamino Arginine Vasopressin