ArticleEuropean journal of clinical pharmacology2009
Distribution of fentanyl in the placental intervillous space and in the different maternal and fetal compartments in term pregnant women.
Article in European journal of clinical pharmacology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05579808 (The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes), which is not on this map. Cited by 12 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes: a Propensity Score-matched Analysis
Who cites it
12 citing papers in PubMed, 32 citations in OpenAlex.
- Pharmacometric modeling of opioid disposition in pregnancy: a systematic review of PopPK and PBPK approaches, model limitations, and future directions.Frontiers in pharmacology · 2026Review
- Association between combined use of epidural analgesia and oxytocin administration during labor and offspring outcomes: a narrative review and proposal.Nagoya journal of medical science · 2024Review
- The impact of opioids on the transcriptional landscape of human villous trophoblasts.Placenta · 2023Article
- Drug exposure during pregnancy: Current understanding and approaches to measure maternal-fetal drug exposure.Frontiers in pharmacology · 2023Review
- The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes: A Propensity Score-Matched Analysis.Journal of clinical medicine · 2022Article
- Predicting Maternal-Fetal Disposition of Fentanyl Following Intravenous and Epidural Administration Using Physiologically Based Pharmacokinetic Modeling.Drug metabolism and disposition: the biological fate of chemicals · 2021Article
- Article
- Human Fetal Liver Metabolism of Oxycodone Is Mediated by CYP3A7.The AAPS journal · 2021Article
- Intrapartum epidural analgesia and low Apgar score among singleton infants born at term: A propensity score matched study.Acta obstetricia et gynecologica Scandinavica · 2020Article
- Placental ABC Transporters: Biological Impact and Pharmaceutical Significance.Pharmaceutical research · 2016Review
- Transplacental Distribution of Lidocaine and Its Metabolite in Peridural Anesthesia Administered to Patients With Gestational Diabetes Mellitus.Reproductive sciences (Thousand Oaks, Calif.) · 2015Article
- CGRP 4218T/C polymorphism correlated with postoperative analgesic effect of fentanyl.International journal of clinical and experimental pathology · 2015Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFentanyl is used in obstetrical practice to promote analgesia and anesthesia during labor and in cesarean delivery, with rapid and short-term effects.
objectiveTo determine fentanyl concentrations in maternal plasma, in the placental intervillous space, and in the umbilical artery and vein in term pregnant women. PATIENTS AND
methodsTen healthy pregnant women underwent epidural anesthesia with fentanyl plus bupivacaine and lidocaine, and fentanyl concentrations were determined in the various maternal and fetal compartments, including the placental intervillous space, which has not been previously studied in the literature.
resultsThe ratios of fentanyl concentrations in the various maternal and fetal compartments revealed an 86% rate of placental fentanyl transfer. The highest fentanyl concentrations were detected in the placental intervillous space, being 2.19 times higher than in maternal plasma, 2.8 times higher than in the umbilical vein and 3.6 times higher than in the umbilical artery, with no significant differences between the umbilical vein and artery, demonstrating that there was no drug uptake by fetal tissues nor metabolism of the drug by the fetus despite the high rates of placental transfer.
conclusionThe present study demonstrated that the placental intervillous space acted as a site of fentanyl deposit, a fact that may be explained by two hypotheses: (1) the blood collected from the placental intervillous space is arterial and, according to some investigators, the arterial plasma concentrations of the drugs administered to patients undergoing epidural anesthesia are higher than the venous concentrations, and (2) a possible role of P-glycoprotein (P-gp).
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