Drug Transport Across the Placental Barrier

This chapter provides an overview of pharmacokinetics of drugs administered during pregnancy, placental development and structure, functions of the human placenta, mechanisms of drug transport across the placenta and mechanisms of drug metabolism within the placenta, strategies. Anatomical and physiological changes in multiple organ systems compared to the nonpregnant state - and even changes associated with gestational age - can affect drug pharmacokinetics and pharmacodynamics during pregnancy. The activity of some drug-metabolizing enzymes is altered during pregnancy, which leads to changes in plasma drug and metabolite concentrations. Nanoparticle-based drug delivery platforms represent a promising tool to control drug delivery across the placental barrier. Indomethacin crosses the placental barrier, and its usefulness is limited by fetal and neonatal side effects such as oligohydramnios and antenatal closure of the ductus arteriosus. Ex vivo placental perfusion is noninvasive and is only experimental model allowing for the study of placental biodisposition of various compounds in organized human tissue.