Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes
In this retrospective cohort study, we aimed to determine the incidence of intraoperative maternal hypotension during fetoscopic surgery for twin-twin transfusion syndrome (TTTS) and to evaluate the impact of intraoperative hypotension on fetal survival. A total of 328 TTTS patients with recipient...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/709059 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850157179543224320 |
|---|---|
| author | Pornswan Ngamprasertwong Mounira Habli Anne Boat Foong Yen Lim Hope Esslinger Lili Ding Senthilkumar Sadhasivam |
| author_facet | Pornswan Ngamprasertwong Mounira Habli Anne Boat Foong Yen Lim Hope Esslinger Lili Ding Senthilkumar Sadhasivam |
| author_sort | Pornswan Ngamprasertwong |
| collection | DOAJ |
| description | In this retrospective cohort study, we aimed to determine the incidence of intraoperative maternal hypotension during fetoscopic surgery for twin-twin transfusion syndrome (TTTS) and to evaluate the impact of intraoperative hypotension on fetal survival. A total of 328 TTTS patients with recipient twin cardiomyopathy who underwent fetoscopic surgery under epidural anesthesia were included. The exposure of interest was maternal medical therapy with nifedipine for the treatment of fetal cardiomyopathy. We found that intraoperative hypotension occurred in 53.4% (175/328 patients). There was no statistically significant difference in incidence of hypotension between nifedipine exposure and nonexposure groups (54.8% versus 50.8%, P=0.479). However, the nifedipine exposure group received a statistically significant higher dose of phenylephrine (7.04 ± 6.38 mcg/kg versus 4.70 ± 4.14 mcg/kg, P=0.018) and higher doses of other vasopressor, as counted by number of treatments (6.06 ± 4.58 versus 4.96 ± 3.42, P=0.022). There were no statistically significant differences in acute fetal survival rate (within 5 days) and fetal survival rate at birth between hypotensive and nonhypotensive patients. We concluded that preoperative exposure to nifedipine resulted in increased intraoperative maternal vasopressor requirement during fetoscopic surgery under epidural anesthesia. In patients who had intraoperative maternal hypotension, there was no correlation between the presence of maternal hypotension and postoperative fetal survival. |
| format | Article |
| id | doaj-art-340d821ccf4f498db467ca59a96f624f |
| institution | OA Journals |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-340d821ccf4f498db467ca59a96f624f2025-08-20T02:24:15ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/709059709059Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival OutcomesPornswan Ngamprasertwong0Mounira Habli1Anne Boat2Foong Yen Lim3Hope Esslinger4Lili Ding5Senthilkumar Sadhasivam6Department of Anesthesia, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USAThe Fetal Care Center, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USADepartment of Anesthesia, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USADivision of Pediatric General and Thoracic Surgery, The Fetal Care Center, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USADepartment of Anesthesia, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USADivision of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USADepartment of Anesthesia, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USAIn this retrospective cohort study, we aimed to determine the incidence of intraoperative maternal hypotension during fetoscopic surgery for twin-twin transfusion syndrome (TTTS) and to evaluate the impact of intraoperative hypotension on fetal survival. A total of 328 TTTS patients with recipient twin cardiomyopathy who underwent fetoscopic surgery under epidural anesthesia were included. The exposure of interest was maternal medical therapy with nifedipine for the treatment of fetal cardiomyopathy. We found that intraoperative hypotension occurred in 53.4% (175/328 patients). There was no statistically significant difference in incidence of hypotension between nifedipine exposure and nonexposure groups (54.8% versus 50.8%, P=0.479). However, the nifedipine exposure group received a statistically significant higher dose of phenylephrine (7.04 ± 6.38 mcg/kg versus 4.70 ± 4.14 mcg/kg, P=0.018) and higher doses of other vasopressor, as counted by number of treatments (6.06 ± 4.58 versus 4.96 ± 3.42, P=0.022). There were no statistically significant differences in acute fetal survival rate (within 5 days) and fetal survival rate at birth between hypotensive and nonhypotensive patients. We concluded that preoperative exposure to nifedipine resulted in increased intraoperative maternal vasopressor requirement during fetoscopic surgery under epidural anesthesia. In patients who had intraoperative maternal hypotension, there was no correlation between the presence of maternal hypotension and postoperative fetal survival.http://dx.doi.org/10.1155/2013/709059 |
| spellingShingle | Pornswan Ngamprasertwong Mounira Habli Anne Boat Foong Yen Lim Hope Esslinger Lili Ding Senthilkumar Sadhasivam Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes The Scientific World Journal |
| title | Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes |
| title_full | Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes |
| title_fullStr | Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes |
| title_full_unstemmed | Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes |
| title_short | Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes |
| title_sort | maternal hypotension during fetoscopic surgery incidence and its impact on fetal survival outcomes |
| url | http://dx.doi.org/10.1155/2013/709059 |
| work_keys_str_mv | AT pornswanngamprasertwong maternalhypotensionduringfetoscopicsurgeryincidenceanditsimpactonfetalsurvivaloutcomes AT mounirahabli maternalhypotensionduringfetoscopicsurgeryincidenceanditsimpactonfetalsurvivaloutcomes AT anneboat maternalhypotensionduringfetoscopicsurgeryincidenceanditsimpactonfetalsurvivaloutcomes AT foongyenlim maternalhypotensionduringfetoscopicsurgeryincidenceanditsimpactonfetalsurvivaloutcomes AT hopeesslinger maternalhypotensionduringfetoscopicsurgeryincidenceanditsimpactonfetalsurvivaloutcomes AT liliding maternalhypotensionduringfetoscopicsurgeryincidenceanditsimpactonfetalsurvivaloutcomes AT senthilkumarsadhasivam maternalhypotensionduringfetoscopicsurgeryincidenceanditsimpactonfetalsurvivaloutcomes |