Myelomeningocele is a malformation with high incidence, and it consists in a neural tube defect. Fetal intrauterine surgery is an alternative for correction, and it improves the prognosis of the fetus, but has an increased risk of maternal complications and premature labor, as it can occur due to uterine stimulation. It is therefore essential that tocolysis is performed before, during and after surgery, and the most commonly used tocolytics are terbutaline and atosiban. Terbutaline has no specificity and may have several adverse effects such as maternal acidosis.
The objective of the study was to evaluate maternal blood gas alterations among cases that used atosiban tocolytic agent and cases with terbutaline in in utero repair of myelomeningocele. It consists of a retrospective cohort study. It included 25 patients, who were divided into two groups, depending on which agent they received as main tocolytic agent during the intrauterine fetal myelomeningocele repair: terbutalineor atosiban. The primary outcome was maternal arterial pH at the end of surgery.
Study Type
OBSERVATIONAL
Enrollment
25
Atosiban intravenous. Dose: attack of 6.75 mg, and maintenance of 300 mcg / min for 3 hours, and 100 mcg / min for 21 hours.
Terbutaline intravenous. Dose: 2.5 mg in 500 mL saline, infusion rate of 30 mL / hr (150 mcg / h) during the surgery and for 24 hours.
Faculdade de Medicina da Universidade de São Paulo
São Paulo, Brazil
Maternal arterial blood pH at the start of surgery
Arterial blood pH
Time frame: Right after intubation
Maternal arterial blood pH at the end of surgery
Arterial blood pH
Time frame: Before extubation
Maternal arterial blood pH at 120 minutes after surgery
Arterial blood pH
Time frame: Two hours after the end of surgery
Short-term fetal repercussions
Fetal heart rate in the immediate postoperative period
Time frame: In the end of the surgery, before extubation
Long-term fetal repercussions
Gestational age at birth
Time frame: At the birth
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