The incidence and spectrum of neurological injury after open fetal surgery

A preterm infant's immature brain is susceptible to both anoxic and hemorrhagic injury during periods of physiological stress. The advent of in utero surgery has created a new population of premature patients at risk for central nervous system (CNS) injury. The aim of this study was to evaluate...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pediatric surgery 1995-08, Vol.30 (8), p.1150-1154
Main Authors: Bealer, John F., Raisanen, Jack, Skarsgard, Erik D., Long, Steven R., Wong, Kondi, Filly, Roy A., Adzick, N.Scott, Harrison, Michael R.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Bradycardia - etiology
Cerebral Hemorrhage - etiology
Cerebrovascular Circulation
Delivery. Postpartum. Lactation
Disorders
Female
Fetal Diseases - etiology
Fetal Diseases - surgery
Fetal Distress - etiology
Fetus - surgery
Gynecology. Andrology. Obstetrics
Hernia, Diaphragmatic - surgery
Humans
Hydrocephalus - etiology
Hypotension - etiology
Hypoxia - complications
Hypoxia, Brain - etiology
Incidence
Infant
Infant, Newborn
Infant, Premature
Leukomalacia, Periventricular - etiology
Male
Maternal-Fetal Exchange
Medical sciences
Miscellaneous
Neurologic Examination
Pregnancy
Pregnancy Complications
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tocolytic Agents - adverse effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A preterm infant's immature brain is susceptible to both anoxic and hemorrhagic injury during periods of physiological stress. The advent of in utero surgery has created a new population of premature patients at risk for central nervous system (CNS) injury. The aim of this study was to evaluate the frequency and nature of CNS injuries in fetal surgical patients. Of 33 fetuses with known neurological outcome after fetal surgery, CNS injuries were identified in seven (21%). Of the seven, four had significant episodes of fetal bradycardia (3) or neonatal hypotension (1), which suggests that asphyxia contributed to the neurological injury. The CNS injuries in the other three patients occurred unexpectedly and without associated signs of fetal distress. The authors speculate that these injuries may have been caused by sudden fluxes in cerebral blood flow, induced by maternal hypoxia (1) or by maternally administered tocolytic drugs (2) used to treat postoperative preterm labor.
ISSN:0022-3468
1531-5037
DOI:10.1016/0022-3468(95)90009-8