Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Impact of partial amniotic carbon dioxide insufflation ( PACI ) on middle cerebral artery blood flow in mid‐gestation human fetuses undergoing fetoscopic surgery for spina bifida aperta

Impact of partial amniotic carbon dioxide insufflation ( PACI ) on middle cerebral artery blood... Letters to the Editor 521 more complex, percutaneous insufflation approach that involves both amniotic and peritoneal cavities was pioneered by our group . The concerns with PACI may have been prompted by the observation of the development of progressive 3,4 fetal acidosis during early insufflation studies in sheep . Before and during the clinical introduction of PACI, 5 – 7 our group also studied its safety in this species .We concluded that the progressive fetal acidosis in sheep observed by other investigators was more likely the result of impaired intercotyledonal blood flow by uterine overdistension associated with maternal laparotomy, too high insufflation pressure, and the uterine-relaxing effects of anesthesia. Given the different anatomy of the human uterus and placenta, and the percutaneous approach which makes it easier to avoid hyperinsufflation, we deemed the finding of these studies not necessarily applicable to the human situation. Because of technical restraints and safety issues, we have not performed fetal blood gas measurements during PACI. Therefore, we prospectively sampled, by pulsed-Doppler Table 1 Middle cerebral artery (MCA) assessment in two human fetuses before minimally invasive fetoscopic surgery for spina bifida aperta (SBA) and within 2 min after partial amniotic carbon dioxide insufflation (PACI) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Ultrasound in Obstetrics & Gynecology Wiley

Impact of partial amniotic carbon dioxide insufflation ( PACI ) on middle cerebral artery blood flow in mid‐gestation human fetuses undergoing fetoscopic surgery for spina bifida aperta

Kohl, T.
Ultrasound in Obstetrics & Gynecology , Volume 47 (4) – Apr 1, 2016
Download PDF
2 pages

Loading next page...
 
/lp/wiley/impact-of-partial-amniotic-carbon-dioxide-insufflation-paci-on-middle-5QqhfZYN14

References (13)

Publisher
Wiley
Copyright
Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd
ISSN
0960-7692
eISSN
1469-0705
DOI
10.1002/uog.15761
pmid
26411355
Publisher site
See Article on Publisher Site

Abstract

Letters to the Editor 521 more complex, percutaneous insufflation approach that involves both amniotic and peritoneal cavities was pioneered by our group . The concerns with PACI may have been prompted by the observation of the development of progressive 3,4 fetal acidosis during early insufflation studies in sheep . Before and during the clinical introduction of PACI, 5 – 7 our group also studied its safety in this species .We concluded that the progressive fetal acidosis in sheep observed by other investigators was more likely the result of impaired intercotyledonal blood flow by uterine overdistension associated with maternal laparotomy, too high insufflation pressure, and the uterine-relaxing effects of anesthesia. Given the different anatomy of the human uterus and placenta, and the percutaneous approach which makes it easier to avoid hyperinsufflation, we deemed the finding of these studies not necessarily applicable to the human situation. Because of technical restraints and safety issues, we have not performed fetal blood gas measurements during PACI. Therefore, we prospectively sampled, by pulsed-Doppler Table 1 Middle cerebral artery (MCA) assessment in two human fetuses before minimally invasive fetoscopic surgery for spina bifida aperta (SBA) and within 2 min after partial amniotic carbon dioxide insufflation (PACI)

Journal

Ultrasound in Obstetrics & Gynecology – Wiley

Published: Apr 1, 2016

There are no references for this article.