Fetal blood-gas values during fetoscopic myelomeningocele repair performed under carbon dioxide insufflation

被引：36
作者：
Baschat, A. A. [1 ]
Ahn, E. S. [2 ]
Murphy, J. [3 ]
Miller, J. L. [1 ]
机构：
[1] Johns Hopkins Sch Med, Dept Obstet & Gynecol, Johns Hopkins Ctr Fetal Therapy, 600 North Wolfe St,Nelson 228, Baltimore, MD 21287 USA
[2] Johns Hopkins Sch Med, Div Pediat Neurosurg, Dept Neurosurg, Baltimore, MD USA
[3] Johns Hopkins Sch Med, Dept Anesthesia & Crit Care Med, Div Obstet Anesthesiol, Baltimore, MD USA
来源：
ULTRASOUND IN OBSTETRICS & GYNECOLOGY | 2018年 / 52卷 / 03期
关键词：
carbon dioxide insufflation; fetal acidosis; fetal surgery; fetoscopy; spina bifida; SURGERY;
D O I：
10.1002/uog.19083
中图分类号：
O42 [声学];
学科分类号：
070206 ; 082403 ;
摘要：
Fetoscopic myelomeningocele (MMC) repair is performed using intrauterine carbon dioxide (CO2) insufflation. Sheep experiments have shown that CO2 insufflation is associated with significant fetal acidemia; however, corresponding data for human pregnancy are not available. We performed umbilical venous cord blood sampling in three patients during fetoscopic MMC repair at 25 + 1, 25 + 3 and 24 + 0 weeks' gestation, respectively. Fetal venous pH at the beginning of CO2 insufflation was 7.36, 7.46 and 7.37, respectively in the three fetuses, and repeat values were 7.28, 7.35 and 7.36 after 181, 159 and 149 min, respectively. The partial pressure of oxygen and CO2 was maintained in the normal range during these times, and pH decrease was less in Patient 3 who received humidified CO2 insufflation. Our observations suggest that, in contrast to sheep experiments, CO2 insufflation during fetoscopic myelomeningocele repair does not cause acidemia in human fetuses. Copyright (c) 2018 ISUOG. Published by John Wiley & Sons Ltd.
引用
收藏
页码：400 / 402
页数：3
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