BACKGROUND: No therapy is currently available to improve the reduced uteroplacental blood flow (UPBF) that characterizes @entity1468 . We hypothesized that sympathectomy induced by epidural local anaesthesia reduces uterine vascular resistance (which is inversely correlated with UPBF) in @entity1468 . METHODS: Ten pregnant @entity1 between 24 and 32 weeks of gestation with @entity1468 and uterine @entity7244 were randomized to @entity400 ( @entity400 ) or control. @entity400 was initiated by a 5 day dose-ranging trial ( @entity400 -1) of 0.04, 0.06, 0.08, and 0.1% @entity1342 and saline placebo, each at 10 ml h(-1) for 24 h. Doses were randomized and double-blind. Doppler ultrasound indices of vascular resistance were assessed at baseline and after each 24 h dosing period in both uterine arteries. Subsequently, these @entity400 @entity1 were administered 0.1% @entity1342 until delivery ( @entity400 -2), with one additional randomized double-blind placebo day. RESULTS: Five @entity1 were randomized to @entity400 . In each @entity1 , one uterine artery exhibited a dose-dependent reduction in vascular resistance (P=0.035), a response that returned to baseline following placebo (P<0.001). The contralateral uterine artery exhibited either increased vascular resistance or no change. In all cases, the uterine artery that responded to @entity400 had higher baseline resistance than its pair (P=0.043). Baseline right-left difference in resistance between paired uterine arteries was greatly diminished following @entity400 . Although @entity400 @entity1 had a mean (sd) duration to delivery of 19 (9) days compared with control 2 (1) days (P=0.008), this should be interpreted with caution because of demographic differences between groups. CONCLUSIONS: @entity400 reduces uterine artery resistance in @entity1468 <32 weeks. Uteroplacental re-distribution is a novel observation and warrants further investigation.

Antepartum continuous epidural @entity1342 therapy reduces uterine artery vascular resistance in XXXX : a randomized, dose-ranging, placebo-controlled study.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient'] @entity7244 :: ('MESH:D020765', 'Disease') :: ['artery flow abnormalities'] @entity1342 :: ('MESH:C037663', 'Chemical') :: ['ropivacaine'] @entity400 :: ('MESH:D014202', 'Disease') :: ['ACET', 'antepartum continuous epidural therapy'] @entity1468 :: ('MESH:D011225', 'Disease') :: ['pre-eclampsia']
@entity1468 :: (MESH:D011225,Disease) :: ['pre-eclampsia']
