Risk Factor: C
Class: Autonomics/ Sympathomimetics (adrenergics)
Fetal Risk Summary
Experience with dopamine in human pregnancy is limited. Since dopamine is indicated only for life-threatening situations, chronic use would not be expected. Animal studies have shown both increases and decreases in uterine blood flow (1,2). In a study in pregnant baboons, dopamine infusion increased uterine vascular resistance and thus impaired uteroplacental perfusion (1). Because of this effect, the investigators concluded that the drug should not be used in patients with severe preeclampsia or eclampsia (1). However, although human studies on uterine perfusion have not been conducted, the use in women with severe toxemia has not been associated with fetal harm. The drug has been used to prevent renal failure in nine oliguric or anuric eclamptic patients by re-establishing diuresis (3). In another study of six women with severe preeclampsia and oliguria, low-dose dopamine (15 g/kg/minute) infusion produced a significant rise in urine and cardiac output (4). No significant changes in blood pressure, central venous pressure, or pulmonary capillary wedge pressure occurred. Dopamine has also been used to treat hypotension in 26 patients undergoing cesarean section (2). No adverse effects attributable to dopamine were observed in the fetuses or newborns of the mothers in these studies.
Breast Feeding Summary
No data are available.
- Fishburne JI Jr, Dormer KJ, Payne GG, Gill PS, Ashrafzadeh AR, Rossavik IK. Effects of amrinone and dopamine on uterine blood flow and vascular responses in the gravid baboon. Am J Obstet Gynecol 1988;158:82937.
- Clark RB, Brunner JA III. Dopamine for the treatment of spinal hypotension during cesarean section. Anesthesiology 1980;53:5147.
- Gerstner G, Grunberger W. Dopamine treatment for prevention of renal failure in patients with severe eclampsia. Clin Exp Obstet Gynecol 1980;7:21922.
- Kirshon B, Lee W, Mauer MB, Cotton DB. Effects of low-dose dopamine therapy in the oliguric patient with preeclampsia. Am J Obstet Gynecol 1988;159:6047.