Fetal bradycardia in open versus fetoscopic prenatal repair of spina bifida.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2024-08-01 Epub Date: 2024-06-14 DOI:10.1002/pd.6626

Steven T Papastefan, Amir M Alhajjat, Katherine C Ott, Daniel R Liesman, Morgan M Langereis, Anne C Boat, Xavier F Pombar, Michelle A Kominiarek, Robin M Bowman, Aimen F Shaaban

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引用次数: 0

Abstract

Objective: To compare the occurrence of fetal bradycardia in open versus fetoscopic fetal spina bifida surgery.

Methods: This is a single-institution retrospective cohort study of patients undergoing open (n = 25) or fetoscopic (n = 26) spina bifida repair between 2017 and 2022. From October 2017 to June 2020, spina bifida repairs were performed via an open classical hysterotomy, and from November 2020 to June 2022 fetoscopic repairs were performed following transition to this technique. Fetal heart rate (FHR) in beats per minute (bpm) was recorded via echocardiography every 15 min during the procedure. Cohort characteristics, fetal bradycardia and maternal physiologic parameters were compared between the groups.

Results: Fetuses undergoing an open repair more frequently developed bradycardia defined as <110 bpm (32% vs. 3.8%, p = 0.008), and a trend was observed for FHR decreases more than 25 bpm from baseline (20% vs. 3.8%, p = 0.073). Profound bradycardia less than 80 bpm was rare, occurring in only three operations (two in open, one in fetoscopic repair) with two fetuses (one in each group) requiring emergency cesarean delivery.

Conclusion: When compared to open fetal surgery, fetal bradycardia occurred less frequently in fetoscopic surgery despite a significantly greater anesthetic exposure and the use of the intraamniotic carbon dioxide insufflation.

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脊柱裂开放式与胎儿镜产前修复术中的胎儿心动过缓。

目的比较开放式与胎儿镜下胎儿脊柱裂手术中胎儿心动过缓的发生率：这是一项单一机构的回顾性队列研究，研究对象为2017年至2022年间接受开放式（n = 25）或胎儿镜（n = 26）脊柱裂修复术的患者。2017年10月至2020年6月，脊柱裂修复术通过开放式经典子宫切开术进行，2020年11月至2022年6月，胎儿镜修复术在过渡到该技术后进行。在手术过程中，每15分钟通过超声心动图记录一次胎儿心率（FHR），单位为每分钟（bpm）。比较了各组的队列特征、胎儿心动过缓和母体生理参数：结果：接受开放式修补术的胎儿更容易出现心动过缓：与开放式胎儿手术相比，尽管胎儿镜手术的麻醉暴露量明显增加，且使用了羊膜腔内二氧化碳充气，但胎儿心动过缓的发生率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling