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Letters to Nature
Nature 229, 124 - 125 (08 January 1971); doi:10.1038/229124a0

Distribution of Pethidine and Chlorpromazine in Maternal, Foetal and Neonatal Biological Fluids

S. E. FIDELMA O'DONOGHUE

The Rotunda Hospital, Dublin

EVIDENCE for placental transfer of drugs was obtained in 1885 when Preyer1 observed mydriasis in newborns whose mothers had received belladonna during labour. Since then analgesia has been recognized as a considerable problem in obstetrics, for the opiates and other allied and synthetic narcotics administered during labour have respiratory depressant effects on the foetus. While the search for optimum analgesia with minimum adverse effects on the foetus continues, pethidine, first introduced in 19402, is still widely used—usually with other drugs. Comprehensive reviews of the literature3,7 relating to placental transfer of pethidine and its suitability for obstetrical use reveal wide discrepancies in clinical observations and a lack of precise experimental results. To provide quantitative data which may be correlated with systematic clinical observations, I examined the distribution of pethidine and chlorpromazine and a wide range of their metabolites in amniotic fluid, maternal and foetal plasma and maternal and neonatal urine.

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References
1. Preyer, W., Specielle Physiologie des Embryo (Leipzig, Grieben, T. 1885).
2. Benthin, W., Dtsch. Med. Wschr., 66, 670 (1940).
3. O'Donoghue, S. E. F. thesis, University of Dublin (1968).
4. Brodie, B. B., Cosmides, G., and Rall, D., Science, 148, 1547 (1965).
5. Hammer, W., Idestrom, C. M., and Syogvist, F., Proc. First Intern. Symp. Antidepressant Drugs (edit. by Garattini, S. and Dikes, M. N. G.), 301 (Excerpta Medica, Amsterdam, 1966).
6. Berkowitz, B. A., Ashling, H. J., Shnider, S. M., and Way, E. L., Clin. Pharmacol. Therap., 10, 320 (1969).
7. Shnider, S. M., and Moya, F., Amer. J. Obst. Gynecol., 69, 1009 (1964).



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