title: Decreased placental and transcellular permeation of cefuroxime in pregnant women with diabetes.
abstract: BACKGROUND
  The present study investigated the transcellular and placental permeation of cefuroxime, an antibiotic used in cesarean sections, in pregnant women with diabetes and hypertension.
  
  
  METHODS
  Fifty-three women scheduled for cesarean section were divided into three groups: healthy women (n = 18), women with arterial hypertension (n = 21), and women with gestational diabetes (n = 14). All women received 1.5 g, i.v., cefuroxime. Cefuroxime concentrations were measured in maternal venous plasma before, during, and after delivery, as well as in fetal umbilical cord vein and artery plasma during delivery. The effects of diabetes and hypertension on cefuroxime placental-permeation were assessed by the fetomaternal plasma concentration ratios. Pharmacokinetic non-compartmental model analyses were performed and results were compared using anova.
  
  
  RESULTS
  Fetomaternal drug concentration ratios were lower in the diabetic group than in the hypertensive and control groups. There were no significant differences in umbilical arterial : venous plasma drug concentration ratios in the diabetic and hypertensive groups compared with the control group. Apparent volume of distribution and clearance were significantly lower in the diabetic group compared with the control and hypertensive groups.
  
  
  CONCLUSIONS
  Diabetes led to decreased placental transfer of cefuroxime, as well as volume of distribution and clearance, but did not affect other pharmacokinetic parameters. Hypertension had no significant effect on the permeation of cefuroxime or on its pharmacokinetics. Prophylactic concentrations of cefuroxime were reached in all groups, but the dosing time of cefuroxime should not be less than 30 min or greater than 2 h prior to delivery.
authors: Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
authors: Mladena
authors: M
authors: Lalic-Popovic
authors: Health Department in Novi Sad for Women Health Protection, Novi Sad, Serbia.
authors: Jovana
authors: J
authors: Paunkovic
authors: Department of Gynecology and Obstetrics, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
authors: Zorica
authors: Z
authors: Grujic
authors: Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
authors: Svetlana
authors: S
authors: Golocorbin-Kon
authors: Department of Gynecology and Obstetrics, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
authors: Ljubomir
authors: L
authors: Milasinovic
authors: School of Pharmacy, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
authors: Hani
authors: H
authors: Al-Salami
authors: Department of Pharmacology, Toxycology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
authors: Momir
authors: M
authors: Mikov
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D019540:Area Under Curve; D001724:Birth Weight; D002444:Cefuroxime / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D002585:Cesarean Section; D002851:Chromatography, High Pressure Liquid; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007231:Infant, Newborn; D007275:Injections, Intravenous; D008297:Male; D008431:Maternal-Fetal Exchange; D008657:Metabolic Clearance Rate; D010539:Permeability; D010920:Placenta / Q000378:metabolism*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime
keywords: cefuroxime; cesarean section; gestational diabetes; hypertension; transplacental transfer; 剖腹产; 头孢呋新; 妊娠糖尿病; 经胎盘转移; 高血压