The incidence and spectrum of neurological injury after open fetal surgery

John F. Bealer, Jack Raisanen, Erik D. Skarsgard, Steven R. Long, Kondi Wong, Roy A. Filly, N. Scott Adzick, Michael R. Harrison

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1150-1154
Number of pages5
JournalJournal of Pediatric Surgery
Volume30
Issue number8
DOIs
StatePublished - Aug 1995

Keywords

  • Fetal surgery
  • intraventricular hemorrhage
  • periventricular leukomalacia

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Bealer, J. F., Raisanen, J., Skarsgard, E. D., Long, S. R., Wong, K., Filly, R. A., Adzick, N. S., & Harrison, M. R. (1995). The incidence and spectrum of neurological injury after open fetal surgery. Journal of Pediatric Surgery, 30(8), 1150-1154. https://doi.org/10.1016/0022-3468(95)90009-8