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Fetal blood‐gas values during fetoscopic myelomeningocele repair performed under carbon dioxide insufflation
Author(s) -
Baschat A. A.,
Ahn E. S.,
Murphy J.,
Miller J. L.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19083
Subject(s) - insufflation , medicine , fetus , anesthesia , umbilical cord , surgery , gestation , venous blood , fetal surgery , pregnancy , in utero , anatomy , biology , genetics
Fetoscopic myelomeningocele (MMC) repair is performed using intrauterine carbon dioxide (CO 2 ) insufflation. Sheep experiments have shown that CO 2 insufflation is associated with significant fetal acidemia; however, corresponding data for human pregnancy are not available. We performed umbilical venous cord blood sampling in three patients during fetoscopic MMC repair at 25 + 1, 25 + 3 and 24 + 0 weeks' gestation, respectively. Fetal venous pH at the beginning of CO 2 insufflation was 7.36, 7.46 and 7.37, respectively in the three fetuses, and repeat values were 7.28, 7.35 and 7.36 after 181, 159 and 149 min, respectively. The partial pressure of oxygen and CO 2 was maintained in the normal range during these times, and pH decrease was less in Patient 3 who received humidified CO 2 insufflation. Our observations suggest that, in contrast to sheep experiments, CO 2 insufflation during fetoscopic myelomeningocele repair does not cause acidemia in human fetuses. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.