MATERNAL OUTCOME AFTER OPEN FETAL SURGERY - A REVIEW OF THE 1ST 17 HUMAN CASES

被引:112
作者
LONGAKER, MT
GOLBUS, MS
FILLY, RA
ROSEN, MA
CHANG, SW
HARRISON, MR
机构
[1] UNIV CALIF SAN FRANCISCO, DEPT SURG,FETAL TREATMENT PROGRAM, 3RD & PARNASSUS AVE,ROOM 585 HSE, SAN FRANCISCO, CA 94143 USA
[2] UNIV CALIF SAN FRANCISCO, DEPT OBSTET GYNECOL & REPROD SCI, SAN FRANCISCO, CA 94143 USA
[3] UNIV CALIF SAN FRANCISCO, DEPT ANESTHESIOL, SAN FRANCISCO, CA 94143 USA
[4] UNIV CALIF SAN FRANCISCO, INST HLTH POLICY STUDIES, SAN FRANCISCO, CA 94143 USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1991年 / 265卷 / 06期
关键词
D O I
10.1001/jama.265.6.737
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A few fetal diseases may benefit from surgical treatment before birth, but hysterotomy and subsequent delivery by cesarean section pose a risk to the otherwise unaffected mother. To assess maternal risk of mortality, morbidity, and reproductive potential after fetal surgery, we reviewed our experience with 17 highly selected women who underwent fetal surgery. Fifteen of these procedures were performed for one of two congenital anomalies: severe bilateral hydronephrosis and congenital diaphragmatic hernia. There were no deaths or serious maternal injuries. In the 14 women who continued pregnancy after hysterotomy, uterine irritability and preterm labor were frequent complications, requiring early confinement in most cases. There has been no detectable effect on future fertility, as indicated by eight subsequent normal pregnancies. We conclude that hysterotomy for fetal surgery can be accomplished without unduly endangering the mother's life or her future reproductive potential. However, morbidity related to premature labor remains a serious problem, and our ability to control uterine contractions after hysterotomy remains the limiting factor in human fetal surgery.
引用
收藏
页码:737 / 741
页数:5
相关论文
共 44 条
[1]   CORRECTION OF CONGENITAL DIAPHRAGMATIC-HERNIA INUTERO .4. AN EARLY GESTATIONAL FETAL LAMB MODEL FOR PULMONARY VASCULAR MORPHOMETRIC ANALYSIS [J].
ADZICK, NS ;
OUTWATER, KM ;
HARRISON, MR ;
DAVIES, P ;
GLICK, PL ;
DELORIMIER, AA ;
REID, LM .
JOURNAL OF PEDIATRIC SURGERY, 1985, 20 (06) :673-680
[2]  
ADZICK NS, 1985, J PEDIATR SURG, V20, P315
[3]   EXPERIMENTAL PULMONARY HYPOPLASIA AND OLIGOHYDRAMNIOS - RELATIVE CONTRIBUTIONS OF LUNG FLUID AND FETAL BREATHING MOVEMENTS [J].
ADZICK, NS ;
HARRISON, MR ;
GLICK, PL ;
VILLA, RL ;
FINKBEINER, W .
JOURNAL OF PEDIATRIC SURGERY, 1984, 19 (06) :658-665
[4]   FETAL SURGERY IN THE PRIMATE .3. MATERNAL OUTCOME AFTER FETAL SURGERY [J].
ADZICK, NS ;
HARRISON, MR ;
GLICK, PL ;
ANDERSON, J ;
VILLA, RL ;
FLAKE, AW ;
LABERGE, JM .
JOURNAL OF PEDIATRIC SURGERY, 1986, 21 (06) :477-480
[5]  
ADZICK NS, 1985, J PEDIATR SURG, V20, P483
[6]  
BOND SJ, 1989, OBSTET GYNECOL, V74, P25
[7]   CONGENITAL DIAPHRAGMATIC-HERNIA DIAGNOSED PRENATALLY BY ULTRASOUND [J].
CHINN, DH ;
FILLY, RA ;
CALLEN, PW ;
NAKAYAMA, DK ;
HARRISON, MR .
RADIOLOGY, 1983, 148 (01) :119-123
[8]   EARLY EXPERIENCE WITH OPEN FETAL SURGERY FOR CONGENITAL HYDRONEPHROSIS [J].
CROMBLEHOLME, TM ;
HARRISON, MR ;
LANGER, JC ;
LONGAKER, MT ;
ANDERSON, RL ;
SLOTNICK, NS ;
FILLY, RA ;
CALLEN, PW ;
GOLDSTEIN, RB ;
GOLBUS, MS .
JOURNAL OF PEDIATRIC SURGERY, 1988, 23 (12) :1114-1121
[9]   TRANS-PLACENTAL CARDIOVERSION OF FETAL SUPRA-VENTRICULAR TACHYCARDIA WITH PROCAINAMIDE [J].
DUMESIC, DA ;
SILVERMAN, NH ;
TOBIAS, S ;
GOLBUS, MS .
NEW ENGLAND JOURNAL OF MEDICINE, 1982, 307 (18) :1128-1131
[10]   FETAL SACROCOCCYGEAL TERATOMA [J].
FLAKE, AW ;
HARRISON, MR ;
ADZICK, NS ;
LABERGE, JM ;
WARSOF, SL .
JOURNAL OF PEDIATRIC SURGERY, 1986, 21 (07) :563-566