PMID: 8938367Feb 1, 1996Paper

The effect of open and endoscopic fetal surgery on uteroplacental oxygen delivery in the sheep

Journal of Pediatric Surgery
F I LuksK Vandenberghe

Abstract

Open fetal surgery predictably results in postoperative uterine contractions and often in premature labor, but its intraoperative effects on the uterus are not known. In 10 pregnant ewes (108 to 115 days' gestation), uterine artery flow, uterine venous oxygen saturation, arterial saturation, and uterine electromyography were recorded simultaneously (control). Six ewes underwent a stapled hysterotomy, and four underwent placement of three endoscopic surgery cannulas and amnioinfusion. Uterine contractions were present 52% of the time (range, 34% to 72%), and there was no significant difference between control, hysterotomy, and endoscopic access. Uterine artery blood flow and uteroplacental oxygen delivery at rest decreased (to 73% of control) after hysterotomy (P < .05), but not after endoscopy. Fetal + uteroplacental oxygen consumption did not differ significantly between the groups. In conclusion, (1) uteroplacental oxygen delivery after hysterotomy alone decreased to levels critical for adequate fetal oxygenation; (2) endoscopy did not alter uteroplacental oxygen delivery; and (3) during open fetal surgery, further oxygen demand/delivery mismatch is likely, by traction on uterine and umbilical vessels and fetal stress.

References

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Citations

Jul 11, 1998·Journal of Pediatric Surgery·K PapadakisT E Lerut
Jul 2, 1999·Obstetrics and Gynecology·J A DeprestR Van Ginderdeuren
Sep 15, 2000·European Journal of Obstetrics, Gynecology, and Reproductive Biology·F I Luks
Feb 1, 1997·Journal of Endourology·C J CalvanoJ Mandell
Nov 26, 1999·Current Opinion in Pulmonary Medicine·Y Kitano, N S Adzick
Apr 18, 2006·Seminars in Pediatric Surgery·Ahmad Marwan, Timothy M Crombleholme
Oct 24, 2006·Seminars in Fetal & Neonatal Medicine·Jan DeprestMarc Van de Velde
May 15, 2013·Journal of Paediatrics and Child Health·Kiarash Taghavi, Spencer Beasley
Apr 23, 2014·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·J DegenhardtT Kohl
Jul 5, 2005·British Journal of Plastic Surgery·N A PapadopulosE Biemer
Dec 18, 1998·Journal of Pediatric Surgery·T KurodaK Miyasaka
Dec 22, 2005·The Annals of Thoracic Surgery·Pirooz EghtesadyPeter Manning
Sep 9, 2004·The Journal of Thoracic and Cardiovascular Surgery·Thomas KohlChristian H Rickert
May 11, 1999·Journal of Pediatric Surgery·D O FauzaS J Fishman
Oct 6, 2006·Current Opinion in Anaesthesiology·Thomas Kohl
Jun 24, 2010·Prenatal Diagnosis·Jan A DeprestMichael R Harrison
Nov 20, 2003·Surgical Endoscopy·J G BusseyT F Tracy
Jun 1, 1999·Current Opinion in Pediatrics·Y Kitano, N S Adzick
Oct 3, 2002·Paediatric Anaesthesia·Laura B MyersC Dean Kurth
Jan 1, 2009·Ophthalmology and Eye Diseases·Sudha NallasamyTerri L Young
Oct 28, 2021·American Journal of Obstetrics & Gynecology MFM·Lennart Van der VeekenJan Deprest

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