Fetal Response to Carbon Dioxide Pneumoperitoneum in the Pregnant Ewe

Barnard, Jerald M.; Chaffin, David G.; Droste, Sabine; Tierney, A. C.; Phernetton, Terrance M.

doi:10.1016/0029-7844(95)00023-k

Cited by 97 publications

(42 citation statements)

References 18 publications

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“…We and others have previously shown that maternal CO 2 insufflation can produce significant fetal hypercapnia and acidosis [1,3,6,17]. Our results suggest that these physiologic effects may have long-term fetal consequences.…”

Section: Discussioncontrasting

confidence: 39%

“…However, despite an increased clinical interest in the effects of abdominal insufflation during pregnancy, few experimental studies have been designed to assess the consequences of insufflation on maternal and fetal well-being. Most of the studies performed in animals have confirmed the clinical suspicions that carbon dioxide (CO 2 ) pneumoperitoneum can produce significant alterations in maternal and fetal blood gases [1,3,6,17]. The significance of these transient effects remains unclear, since none of the studies has assessed the long-term postnatal consequences associated with maternal pneumoperitoneum.…”

mentioning

confidence: 83%

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Early postnatal behavior deficits after maternal carbon dioxide pneumoperitoneum during pregnancy

et al. 2003

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Section: Discussioncontrasting

confidence: 39%

mentioning

confidence: 83%

Early postnatal behavior deficits after maternal carbon dioxide pneumoperitoneum during pregnancy

et al. 2003

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“…Se trata de un riesgo que es mayor durante la entrada primaria, el cual puede reducirse al utilizar visión directa con cámara (32,33). Respecto al CO2 y su absorción fetal, ha sido estudiado y no se considera un factor de riesgo en la actualidad (34)(35)(36)(37). Las presiones intra-abdominales de CO2 se manejaron en un rango de 15 a 20 mmHg.…”

Section: Discussionunclassified

Manejo Laparoscópico De Quistes Ováricos Complicados O Persistentes Durante El Embarazo

Albornoz

et al. 2009

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: El incremento en el hallazgo de quistes anexiales durante el embarazo sería el mayor uso de técnicas de reproducción asistida con hiperestimulación ovárica controlada. La complicación más frecuente sigue siendo la torsión anexial. Objetivo: Revisar el manejo de quistes anexiales complicados o persistentes, durante el embarazo, con resolución laparoscópica. Método: Revisión retrospectiva de 9 pacientes consecutivas, ingresadas al Departamento de Obstetricia y Ginecología Clínica Las Condes. Resultados: La edad gestacional de ingreso fue entre 5+5 y 27 semanas. Cinco casos fueron producto de fertilización asistida y cuatro espontáneos. Ocho (85,6%) embarazadas, ingresaron por dolor abdominal agudo. Otro caso ingresó a cirugía electiva por quiste ovárico persistente. Los quistes tenían entre 6 y 13 cm. En 5 se realizó sólo destorsión ovárica, en 1 ooforectomía y en 1 quistectomía. Se realizó punción, destorsión y fijación a ligamento útero ovárico, bilateral, en la otra paciente. Se registró un caso de fiebre en el postoperatorio. El alta hospitalaria fue a las 48 horas en 6 (67%), a las 72 en 2 y a las 96 en 1. El estudio biópsico diferido en 3 pacientes demostró: 1 quiste seroso paratubario, 1 quiste luteínico parcialmente hemorrágico y 1 infarto anexial. Todos los embarazos evolucionaron normalmente. Conclusión: Nuestra experiencia confirma que en el embarazo la laparoscopía es una buena opción al requerir una cirugía por quiste anexial complicado o persistente. PALABRAS CLAVE: Torsión anexial, laparoscopia, hiperestimulación ovárica, embarazo SUMMARYBackground: Recent reviews show an increase in the finding of adnexal cysts during pregnancy. One reason could be the use of assisted reproductive techniques with controlled ovarian hyperstimulation. Objective: To review the experience in managing via laparoscopy complicated or persistent adnexal cysts during pregnancy. Method: Retrospective review of 9 consecutive patients, admitted at the Department of Obstetrics and Gynecology, Clinica Las Condes. Results: The gestational age was between 5+5 and 27 weeks. Five were the product of assisted fertilization and four spontaneous. Eight (85.6%) pregnant women were admitted by emergency room because of acute abdominal pain and another one went through elective surgery for persistent ovarian cyst. Preoperative diagnosis of the 8 patients admitted by emergency: adnexal cyst complicated with torsion in 6 (1 adnexal infarction) and 2 cases of acute abdomen. The cysts were between 6 and 13 cm. Type of surgery: in 5, only detorsion; ovarian oophorectomy in 1 and cystectomy in one. Puncture, detorsion and bilateral fixation of uterine ovarian ligament, in another patient. One case required conversion to laparotomy with adnexectomy. Postoperative fever was observed in one patient. Discharge was at 48 hrs

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“…Some animal studies have confirmed fetal acidosis with associated tachycardia, hypertension, and hypercapnia during CO 2 pneumoperitoneum [83][84][85]. Other animal studies have demonstrated no fetal acidosis [86]. Regardless, no long-term adverse effects have been identified [83][84][85][86].…”

Section: Insufflation Pressurementioning

confidence: 93%

Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy

Surgeons¹,

Hori

2008

Surg Endosc

146

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Fetal Response to Carbon Dioxide Pneumoperitoneum in the Pregnant Ewe

Abstract: The sheep fetus has sufficient placental flow reserves or compensatory responses to maintain adequate gas exchange during a 1-hour, 20 mmHg maternal pneumoperitoneum. Laparoscopic surgical procedures may prove to be a safe alternative to laparotomy during pregnancy.

Cited by 97 publications

References 18 publications

Early postnatal behavior deficits after maternal carbon dioxide pneumoperitoneum during pregnancy

Early postnatal behavior deficits after maternal carbon dioxide pneumoperitoneum during pregnancy

Manejo Laparoscópico De Quistes Ováricos Complicados O Persistentes Durante El Embarazo

Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy

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