Protective effects of indomethacin and dexamethasone in a goat model with intrauterine balloon aortic valvuloplasty.
BACKGROUND
Intrauterine balloon aortic valvuloplasty (IUBAV) has been used for critical aortic stenosis. However, it is necessary to determine the fetal impairments such as preterm birth after this approach and to find a way to prevent or reduce them.


METHODS
In the present study, we evaluated the therapeutic value of indomethacin (IDM) and dexamethasone (DXS) on reducing the preterm birth rate in experimental goats after IUBAV.


RESULTS
Our results indicated that the administration of IDM/DXS significantly reduced the rate of premature birth. IDM/DXS treatment led to preservation of myocardial ultrastructure with less damage, and amelioration of the fetal and placental circulation. Furthermore, we found that norepinephrine (NE) level was positively associated with the degree of myocardial damage. IDM/DXS administration led to a significant decrease of operation-induced increase of NE levels, which may be associated with the protective effects of IDM/DXS. Lastly, we found that the administration of IDM/DXS did not induce the risk of ductus arteriosus closure or slow down fetal growth.


CONCLUSIONS
Our results indicate that IDM/DXS promotes a better gestational outcome at least partially by reducing stress response during and after the operation of IUBAV in the goat model. IDM/DXS may be a useful application in human patients during IUBAV intervention.
Department of Pediatric Cardiology, Second University Hospital and West China Medical School, Sichuan University, Chengdu 610041, China.
Kaiyu
K
Zhou
Gang
G
Wu
Yifei
Y
Li
Liang
L
Zhao
Rong
R
Zhou
Qi
Q
Zhu
Xupei
X
Huang
Dezhi
D
Mu
Yimin
Y
Hua
D000818:Animals; D001024:Aortic Valve Stenosis / Q000188:drug therapy; D063126:Balloon Valvuloplasty / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006041:Goats; D007213:Indomethacin / Q000627:therapeutic use*; D023421:Models, Animal; D011247:Pregnancy; D047928:Premature Birth / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D013312:Stress, Physiological / Q000187:drug effects
D003907:Dexamethasone; D007213:Indomethacin