Prevention of the generalized Shwartzman reaction in pregnant rats by prostacyclin infusion.

The effects of prostacyclin infusion on endotoxin-induced generalized Shwartzman reaction were studied in pregnant rats. Four hours after administration of Escherichia coli endotoxin (0.4 mg) to pregnant rats on the 20th day of gestation, fibrin and platelet thrombi were observed in 72% of the animals. These findings were associated with a decrease in renal blood flow and glomerular filtration rate from 7.0 to 0.7 and 0.8 +/- 0.1 to 2.6 +/- 0.4 and 0.2 +/- 0.8 ml/minute, respectively (p less than 0.0001 and less than 0.05) and a decrease in platelet count (p less than 0.05). The infusion of prostacyclin, at a mean dose of 57 ng/kg/minute prior to and after administration of endotoxin strikingly inhibited the development of fibrin and platelet thrombi in glomerular capillaries (p less than 0.001). Despite hemodynamic changes which were similar to those in control animals, renal blood flow and glomerular filtration rate decreased from 7.2 +/- 0.2 and 0.9 to 2.9 +/- 0.03 and 0.3 +/- 0.1 ml/minute, respectively (p less than 0.001 and less than 0.025). In addition, the mean blood pressure decreased from 118 +/- 3.8 to 86 +/- 3.7 mm Hg (p less than 0.025), whereas the platelet count remained normal. We conclude that prostacyclin infusion prior to endotoxin administration significantly inhibits endotoxin-induced generalized Shwartzman reaction in pregnant rats.