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Effects of amniodistention with carbon dioxide on fetal acid-base status during fetoscopic surgery in a sheep model.
- Source :
- Surgical Endoscopy; Apr2001, Vol. 15 Issue 4, p368-372, 5p
- Publication Year :
- 2001
-
Abstract
- <bold>Background: </bold>Because the data from previous experiments on the fetal effects of carbon dioxide (CO2) amniodistention in endoscopic fetal surgery are conflicting, we set out to evaluate the fetal acid-base status during CO2 amniodistention, with or without maternal hyperventilation, using a sheep model for endoscopic surgery.<bold>Methods: </bold>We assigned 26 pregnant ewes undergoing amniodistention with CO2 (4-5 mmHg intraamniotic pressure) to one of the following three groups: group I had fetal surgery + no maternal hyperventilation (n = 10); group II had fetal surgery + maternal hyperventilation (n = 10); group III had no fetal surgery + maternal hyperventilation (n = 6). Hyperventilation kept CO2 at 29-31 mmHg; in its absence, pCO2 ranged from 38 to 41. Fetal surgery consisted of fetoscopic tracheal clipping. Maternal blood pressure (mean, 98/69 mmHg) and heart rate (mean, 72 bpm) were kept at values comparable to human pregnancy. Fetal and maternal blood gas measurements were taken every 15 min during 1 h of amniodistention.<bold>Results: </bold>The ranges for baseline mean fetal pCO2 (mmHg) and pH were 51-55 and 7.24-7.25, respectively, in all study groups. After 1 h of amniodistention, mean +/- SEM values of fetal pCO2 and pH were 88 +/- 3 and 7.06 +/- 0.03 in group I, 69 +/- 4 and 7.13 +/- 0.02 in group II, and 71 +/- 5 and 7.14 +/- 0.04 in group III, respectively. Therefore, maternal hyperventilation attenuated but could not prevent significant fetal hypercarbia and acidosis. Fetal surgical manipulation had no effect on these observations.<bold>Conclusion: </bold>CO2 amniodistention should not be considered for clinical practice until ways of preventing its effects on the fetal acid-base status can be demonstrated. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09302794
- Volume :
- 15
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 50024651
- Full Text :
- https://doi.org/10.1007/s004640090024