Abstract
Beta-adrenerjik reseptor bloke edici olan propranolol, gebelik döneminde de hipertansiyon için sık kullanılan ilaçlardandır. Ancak fetus ve yenidoğanlarda propranolole bağlı ciddi yan etkiler bildirildiğinden, gebelikte kullanımıyla ilgili çelişkiler vardır. Burada hastanemizde dirençli hipoglisemi nedeniyle tedavi edilen ve etyolojisi araştırıldığında annelerinin gebeliğin son üç ayı içerisinde uzun süreli beta adrenerjik bloke edici ilaç (propranalol) kullandığı saptanan iki yenidoğan sunulmaktadır. Her iki olgu apne, bradıkardi ve oksijen satürasyonunda düşme nedeniyle yenidoğan servisimize yatırılarak izlenmiş, klinik tablonun hipoglisemiye sekonder geliştiği anlaşılmış, dirençli hipoglisemileri, nedeniyle uzun süreli (9/15 gün) yüksek glukoz infüzyonu (22 mg/kg/dk) ve olgulardan birinde ek olarak metil prednisolon (2 mg/kg/gün) tedavisi gerekmiştir. Bu iki olgu nedeniyle gebe ve emziren annelerde ilaç tedavilerinin bebekte oluşturacağı yan etkiler düşünülerek dikkatli seçim yapılması gerektiği, gebelikte beta-blokör kullanan annelerden doğan bebeklerin doğum sonrası yakın izlenmesi gerektiği düşünülmüştür. Propranolol kullanan gebelerin bebeklerinde olası yan etkilerin erken tedavisi, uzun dönemde oluşabilecek komplikasyonların önlenmesi açısından önemlidir. Yenidoğanlarda dirençli hipoglisemi varlığında öyküde annenin kullandığı ilaçların dikkatlice sorgulanması, etyolojinin belirlenmesinde önem taşımaktadır.
Keywords
References
- Munski UK, Deorari AK, Paul VK, Singh M. Effects of maternal labetalol on the newborn infant. Indian Pediatr 1992; 29:1507-1512.
- Klar JM, Bhatt-Mehta V, Donn SM. Neonatal adrenergic blockade following single dose maternal labetalol administration. Am J Perina- Fox RE, Marx C, Stark AR. Neonatal effects of maternal nadolol therapy. Am J Obstet Gynecol 1985; 152: 1045-1046.
- Boutroy MJ. Fetal and neonatal effects of the beta-adrenoreceptor blocking agents. Dev Pharmacol Ther 1987; 10: 224-231.
- Bott-Kanner G, Schweitzer A, Reisner SH, Joel-Cohen SJ, Rosenfeld JB. Propranolol and hydrallazine in the management of essential tol 1994; 11: 91-93. newborn of mother treated with labetalol. Rev Esp Anestesiol Reanim 1993; 40: 146-147. hypertension in pregnancy. Br J Obstet Gynaecol 1980; 87: 110-114.
- Sala X, Monsalve C, Comas C, Botet F, Nalda MA. Cardiac arrest in Lieberman BA, Stirrat GM, Cohen SL, Beard RW, Pinker GD, Belsey E. The possible adverse effect of propranolol on fetus in pregnancies. Crooks BN, Deshpande SA, Hall C, Platt MP, Milligan DW. Adverse neonatal effects of maternal labetalol treatment. Arch Dis Child Fetal Neonatal Ed 1998; 79: F150-F151.
Abstract
Propranolol, one of the beta-adrenergic blocking agents, has an important role in the practice of general medicine and pregnancy induced hypertension. However, its use in pregnant women with pregnancy induced hypertension is contradictary, owing to a number of detrimental side effects that have been reported in the fetus and neonate. In this report, we reported two neonates with refractory hypoglycemia whose mothers have been treated with propranolol during gestation. Both newborns were admitted to our hospital due to cyanosis and determined hypoglycemia and apnea. They were treated with high glucose infusion (22 mg/kg/minute) and one of them required methyl- prednisolone therapy (2 mg/kg/day). We suggest that the women during pregnancy and lactation should be carefully treated, and the mode of therapy should be carefully determined due to possible fetal and neonatal side effects. The neonates born to mothers treated with betaadrenergic blocking agents (i.e. propranolol) during gestation should be closely monitored for hypoglisemia after delivery. Early treatment of possible side effects are important for beter longterm outcome. The history of maternal propranolol use should be carefully questioned in the neonates with refractory hypoglycemia
Keywords
References
- Munski UK, Deorari AK, Paul VK, Singh M. Effects of maternal labetalol on the newborn infant. Indian Pediatr 1992; 29:1507-1512.
- Klar JM, Bhatt-Mehta V, Donn SM. Neonatal adrenergic blockade following single dose maternal labetalol administration. Am J Perina- Fox RE, Marx C, Stark AR. Neonatal effects of maternal nadolol therapy. Am J Obstet Gynecol 1985; 152: 1045-1046.
- Boutroy MJ. Fetal and neonatal effects of the beta-adrenoreceptor blocking agents. Dev Pharmacol Ther 1987; 10: 224-231.
- Bott-Kanner G, Schweitzer A, Reisner SH, Joel-Cohen SJ, Rosenfeld JB. Propranolol and hydrallazine in the management of essential tol 1994; 11: 91-93. newborn of mother treated with labetalol. Rev Esp Anestesiol Reanim 1993; 40: 146-147. hypertension in pregnancy. Br J Obstet Gynaecol 1980; 87: 110-114.
- Sala X, Monsalve C, Comas C, Botet F, Nalda MA. Cardiac arrest in Lieberman BA, Stirrat GM, Cohen SL, Beard RW, Pinker GD, Belsey E. The possible adverse effect of propranolol on fetus in pregnancies. Crooks BN, Deshpande SA, Hall C, Platt MP, Milligan DW. Adverse neonatal effects of maternal labetalol treatment. Arch Dis Child Fetal Neonatal Ed 1998; 79: F150-F151.
Details
| Other ID | JA89GP96DH |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | August 1, 2008 |
| Submission Date | August 1, 2008 |
| Published in Issue | Year 2008 Volume: 2 Issue: 1 |
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The publication language of Turkish Journal of Pediatric Disease is English.
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