Wang X, Zhang Y, Yang H, Xu Y. Maternal-fetal transfer of indocyanine green: a systematic review.
J Matern Fetal Neonatal Med 2021;
35:8181-8185. [PMID:
34565270 DOI:
10.1080/14767058.2021.1966410]
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Abstract
RATIONAL
In a survey of 1101 members of vitreoretinal trained physicians regarding the use of ICG angiography during pregnancy, 434 (83%) of 520 respondents had seen at least one pregnant woman requiring ICG angiography or fluorescein angiography. One hundred and five (24%) withheld ICG angiography, mostly because of fear of teratogenicity or lawsuit. Adverse reactions to fluorescein and ICG are rare and may be classified as toxic, hypersensitivity, and non-specific. This literature review aimed to review evaluate the maternal-to-fetal transfer of ICG and resume the most recent recommendations for ICG use in its obstetric applications.
METHODS
The available literature was examined using PubMed-Medline, and web of science, and using the MeSH terms "fluorescein," "Indocyanine green," and "pregnancy" according to PRISMA-P guidelines.
RESULTS
Studies in humans demonstrated that ICG is not detectable in fetal cord blood or umbilical vein blood collected immediately after birth. ICG maternal-to-fetal transfer is slow and is safe during pregnancy. ICG in the fetus accumulates in the liver and accumulation is enhanced by the administration of OATPs or P-gp inhibitors.
CONCLUSIONS
ICG's transplacental transfer is minimal and is probably medicine-mediated, like rifampin. The placenta is an effective protective barrier to ICG's distribution into the fetus.
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