Cutaneous polyarteritis.
Cutaneous polyarteritis.
复制标题
皮肤多动脉炎。
DOI：
10.1136/bmj.1.5844.6
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发表时间：
1973
影响因子：
--
通讯作者：
T. Dyk
中科院分区：
文献类型：
--
作者：
T. Dyk
on its aibility to establish satisfactory respiration after delivery. Potentially toxic substances may also be transmitted to the baby in breast milk.3 More recently two new types of toxic effects on the fetus have been described. Aspirin and promethazine have been shown to interfere with platelet aggregation in the blood of the baby to a much greater extent than in that of the mother across whose placenta they have been transmitted.45 That barbiturate withdrawal symptoms in the baby have been described only this year67 is presumably due to the fact that their onset may be delayed for up to 14 days after birth and so go unnoticed, whereas the similar effect in babies of narcotic addicts is usually apparent within 24 hours-and it was recognized 13 years ago.8 Clearly a combination of laboratory studies and thorough clinical observation must be employed in any attempt to define the possible toxic effects on the fetus of any drug which is intended to have a therapeutic effect on its mother. A report by R. D. G. Milner and S. K. Chouksey9 of the effects of fetal exposure to diazoxide is an excellent example of such an investigation of a new form of treatment. Diazoxide in a dose of 200-400 mg per day was administered to four women with severe pre-eclamptic toxaemia for between 19 and 69 days before delivery. It appeared to have a beneficial effect in helping to prolong each of the pregnancies to a stage at which the baby had an improved chance of survival. The diazoxide, which was present in the cord plasma at about half the maternal level, was excreted in the baby's urine during the first week of life. There was no adverse effect on the blood pressure or blood sugar level during the first day or two of life, nor on blood counts, immunoglobulins, or later ocular development. There was some retardation of ossification in the wrist of one baby, but all four showed some degree of alopecia, and one developed hypertrichosis lanuginosa (a reported complication of diazoxide treatment of hypoglycaemia in childhood). These abnormalities of hair growth were first noted at the age of 1 week and were still present at the time of the report, when the babies were aged 5-12 months, so that their prognosis was uncertain. But they do not appear to have been sufficiently severe to outweigh the apparent advantages of the treatment. It seems likely that in the future there will be an increasing demand for similar careful balancing of perinatal therapeutic and toxic effects of drugs.
