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Fetal Heart Rate Monitoring during Intrauterine Open Surgery for Myelomeningocele Repair.
Santana, Eduardo Félix Martins; Moron, Antônio Fernandes; Barbosa, Maurício Mendes; Milani, Herbene Jose Figuinha; Sarmento, Stephanno Gomes Pereira; Araujo Júnior, Edward; Rolo, Liliam Cristine; Cavalheiro, Sérgio.
Afiliación
  • Santana EF; Fetal Surgery Unit, Discipline of Fetal Medicine, Department of Obstetrics, Paulista School of Medicine, Sx00E3;o Paulo Federal University (EPM-UNIFESP), Sx00E3;o Paulo, Brazil.
Fetal Diagn Ther ; 39(3): 172-8, 2016.
Article en En | MEDLINE | ID: mdl-26304733
OBJECTIVE: The aim of this study was to assess fetal hemodynamics during intrauterine open surgery for myelomeningocele (MMC) repair by describing fetal heart rate (FHR) monitoring in detail related to each part of the procedure. METHODS: A study was performed with 57 fetuses submitted to intrauterine MMC repair between the 24th and 27th week of gestation. Evaluations of FHR were made in specific periods: before anesthesia, after anesthesia, at the beginning of laparotomy, during uterus abdominal withdrawal, hysterotomy, neurosurgery (before incision, during early skin manipulation, spinal cord releasing, and at the end of neurosurgery), abdominal cavity reintroduction, and abdominal closure, and at the end of surgery. Means ± standard deviations of FHR were established for each period, and analysis of variance with repeated measures was used to assess differences between these periods. The mean differences were assessed with 95% confidence intervals and were analyzed by Tukey's multiple comparison test. RESULTS: The mean FHR during the specific periods mentioned above was 140.2, 140, 139.2, 138.8, 135.1, 133.9, 123.1, 134.0, 134.5, 137.9, and 139.9 bpm, respectively (p < 0.0001). Comparing the different periods, the highest frequencies were observed in the initial and final moments. The neurosurgery stage presents lower frequencies, especially during the release of the spinal cord. CONCLUSION: FHR monitoring revealed interesting findings in terms of physiological fetal changes during MMC repair, especially during neurosurgery, which was the most critical period.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Frecuencia Cardíaca Fetal / Meningomielocele / Monitoreo Fetal / Feto Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Fetal Diagn Ther Asunto de la revista: DIAGNOSTICO POR IMAGEM / OBSTETRICIA / PERINATOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Frecuencia Cardíaca Fetal / Meningomielocele / Monitoreo Fetal / Feto Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Fetal Diagn Ther Asunto de la revista: DIAGNOSTICO POR IMAGEM / OBSTETRICIA / PERINATOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza