Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele Repair

Effective tocolysis is essential after fetal myelomeningocele repair and is associated with the development of pulmonary edema. The increased uterine activity in the immediate postoperative period is commonly treated with magnesium sulfate. However, other tocolytic agents such as nitroglycerine, nif...

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Main Authors: Denis Snegovskikh, Konstantina Svokos, Dmitri Souza, Elizabeth Renaud, Stephen R. Carr, Mark C. Kendall, Francois I. Luks
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2021/6679845
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author Denis Snegovskikh
Konstantina Svokos
Dmitri Souza
Elizabeth Renaud
Stephen R. Carr
Mark C. Kendall
Francois I. Luks
author_facet Denis Snegovskikh
Konstantina Svokos
Dmitri Souza
Elizabeth Renaud
Stephen R. Carr
Mark C. Kendall
Francois I. Luks
author_sort Denis Snegovskikh
collection DOAJ
description Effective tocolysis is essential after fetal myelomeningocele repair and is associated with the development of pulmonary edema. The increased uterine activity in the immediate postoperative period is commonly treated with magnesium sulfate. However, other tocolytic agents such as nitroglycerine, nifedipine, indomethacin, terbutaline, and atosiban (outside the US) have also been used to combat uterine contractility. The ideal tocolytic regimen which balances the risks and benefits of in-utero surgery has yet to be determined. In this case report, we describe a unique case of fetal myelomeningocele repair complicated by maternal pulmonary edema and increased uterine activity resistant to magnesium sulfate therapy.
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spelling doaj-art-d238cfdd7a174b55bd00a67de9233a832025-08-20T02:19:43ZengWileyCase Reports in Anesthesiology2090-63822090-63902021-01-01202110.1155/2021/66798456679845Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele RepairDenis Snegovskikh0Konstantina Svokos1Dmitri Souza2Elizabeth Renaud3Stephen R. Carr4Mark C. Kendall5Francois I. Luks6Department of Anesthesiology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USADepartment of Neurosurgery, Rhode Island Hospital, Hasbro Children’s Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USADepartment of Anesthesiology, Ohio University, Heritage College of Osteopathic Medicine, Athens, OH 45701, USADepartment of Pediatric Surgery, Hasbro Children’s Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USADivision of Maternal-Fetal Medicine, Women and Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USADepartment of Anesthesiology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USADivision of Pediatric Surgery, Hasbro Children’s Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USAEffective tocolysis is essential after fetal myelomeningocele repair and is associated with the development of pulmonary edema. The increased uterine activity in the immediate postoperative period is commonly treated with magnesium sulfate. However, other tocolytic agents such as nitroglycerine, nifedipine, indomethacin, terbutaline, and atosiban (outside the US) have also been used to combat uterine contractility. The ideal tocolytic regimen which balances the risks and benefits of in-utero surgery has yet to be determined. In this case report, we describe a unique case of fetal myelomeningocele repair complicated by maternal pulmonary edema and increased uterine activity resistant to magnesium sulfate therapy.http://dx.doi.org/10.1155/2021/6679845
spellingShingle Denis Snegovskikh
Konstantina Svokos
Dmitri Souza
Elizabeth Renaud
Stephen R. Carr
Mark C. Kendall
Francois I. Luks
Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele Repair
Case Reports in Anesthesiology
title Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele Repair
title_full Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele Repair
title_fullStr Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele Repair
title_full_unstemmed Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele Repair
title_short Successful Anesthesia Management of Postoperative Maternal Pulmonary Edema and Uterine Hyperactivity following Open Fetal Myelomeningocele Repair
title_sort successful anesthesia management of postoperative maternal pulmonary edema and uterine hyperactivity following open fetal myelomeningocele repair
url http://dx.doi.org/10.1155/2021/6679845
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