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Fetally‐injected drugs for immobilization and analgesia do not modify fetal brain development in a rabbit model
Author(s) -
Veeken Lennart,
Inversetti Annalisa,
Galgano Angela,
Bleeser Tom,
Papastefanou Ioannis,
Merwe Johannes,
Rex Steffen,
Deprest Jan
Publication year - 2021
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5954
Subject(s) - medicine , fetus , fentanyl , anesthesia , hippocampus , in utero , pregnancy , biology , genetics
Abstract Objective During fetal surgery, fetuses receive medication (atropine‐fentanyl‐curare) to prevent fetal pain, movement and bradycardia. Although essential there has been no detailed review of potential side effects. Herein we aimed to assess the effects of this medication cocktail on fetal brain development in a rabbit model. Methods Pregnant does underwent laparotomy at 28 days of gestation. Two pups of each horn were randomized to an ultrasound guided injection with medication (atropine‐cisatracurium‐fentanyl, as clinically used) or saline (sham). The third pup was used as control. At term, does were delivered by cesarean. Outcome measures were neonatal biometry, neuromotoric functioning and neuro‐histology (neuron density, synaptic density and proliferation). Results Maternal vital parameters remained stable during surgery. Fetal heart rates did not differ before and after injection, and were comparable for the three groups. At birth, neonatal body weights and brain‐to‐body weight ratios were also comparable. Both motor and sensory neurobehavioral scores were comparable. There were no differences in neuron density or proliferation. Sham pups, had a lower synaptic density in the hippocampus as compared to the medication group, however there was no difference in the other brain areas. Conclusion In the rabbit model, fetal medication does not appear to lead to short‐term neurocognitive effects.