Effects of Maternal Abdominal Surgery on Fetal Brain Development in the Rabbit Model

Bleeser, Tom; Veeken, Lennart Van der; Devroe, Sarah; Vergote, Simen; Emam, Doaa; Merwe, Johannes van der; Ghijsens, Elina; Joyeux, Luc; Basurto, David; Velde, Marc Van de; Deprest, Jan; Rex, Steffen

doi:10.1159/000512489

Cited by 9 publications

(9 citation statements)

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“…Secondly, the rabbit is a relevant model to investigate foetal brain development 14 . Thirdly, the analysis of brain histology and neurobehaviour has been validated 17–19 . Fourthly, the rabbit model enables the use of monitoring standards of the American Society of Anesthesiologists 17–19 …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The pups were placed in a humidified and warmed incubator and were fed 3 h later (Supplement 2.2, http://links.lww.com/EJA/A695, Supplemental Video 2, http://links.lww.com/EJA/A692). [17][18][19] The neurobehaviour of the pups was evaluated 24 h after birth using a validated scale assessing sensory and motor aspects. [17][18][19] The videos of these evaluations were scored by two blinded observers (Supplement 3.1, http://links.…”

Section: Anaesthesia and Surgerymentioning

confidence: 99%

“…[17][18][19] The neurobehaviour of the pups was evaluated 24 h after birth using a validated scale assessing sensory and motor aspects. [17][18][19] The videos of these evaluations were scored by two blinded observers (Supplement 3.1, http://links. lww.com/EJA/A695, Supplemental Video 2, http://links.…”

Section: Anaesthesia and Surgerymentioning

confidence: 99%

“…14 Thirdly, the analysis of brain histology and neurobehaviour has been validated. [17][18][19] Fourthly, the rabbit model enables the use of monitoring standards of the American Society of Anesthesiologists. [17][18][19] Future studies Given the paucity of human data on noradrenaline in pregnancy, observational clinical studies are warranted to investigate the effects of noradrenaline during general anaesthesia on uterine blood flow and foetal well being.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

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Neurodevelopmetal effects of maternal blood pressure management with noradrenaline during general anaesthesia for nonobstetric surgery in the pregnant rabbit model

Bleeser

Veeken²,

Basurto³

et al. 2022

European Journal of Anaesthesiology

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BACKGROUNDIn pregnant women, anaesthesia-induced hypotension is commonly treated using phenylephrine or noradrenaline, the rationale being to maintain uterine perfusion pressure and thereby uterine blood flow. Evidence for this strategy during general anaesthesia for nonobstetric surgery is absent.OBJECTIVETo analyse the effects of treating anaesthesia-induced hypotension with noradrenaline on brain development of rabbit foetuses of mothers subjected to general anaesthesia for nonobstetric surgery. We hypothesised that treatment of maternal hypotension would improve foetal outcomes.DESIGNRandomised controlled laboratory study using 21 pregnant rabbits (does) at 28 days of gestation.INTERVENTIONTwo hours of sevoflurane anaesthesia for a laparotomy without treatment of anaesthesia-induced hypotension (hypotension group) or with maintaining maternal mean arterial pressure above 80% of the awake value using noradrenaline (noradrenaline group). In the control group, does remained untouched. At term, all pups were delivered by caesarean section. One day later, the neurobehaviour of the pups was assessed and brains were harvested.MAIN OUTCOMESNeuron density in the frontal cortex for the comparison of noradrenaline groups versus hypotension groups was the primary outcome; the neurobehavioural scores and other histological outcomes were secondary outcomes.RESULTSIn the noradrenaline groups and hypotension groups, neuron density in the frontal cortex was similar (1181 ± 162 versus 1189 ± 200 neurons mm−2, P = 0.870). However, significantly less foetal survival, lower sensory scores in neurobehavioural assessment and less proliferation were observed in the noradrenaline group when compared with the hypotension group. Neuron densities in other regions, total cell densities, biometrics and synaptogenesis were not affected. There were no differences between the control group and hypotension group.CONCLUSIONDuring general anaesthesia for nonobstetric surgery in rabbits, treatment of anaesthesia-induced hypotension using noradrenaline did not affect neuron densities but was associated with impaired foetal outcomes according to several secondary outcome parameters. Further studies are needed to investigate any clinical relevance and to determine the target blood pressure in pregnant women during general anaesthesia.KEY POINTSIn pregnant women, anaesthesia-induced hypotension is commonly treated using phenylephrine or noradrenaline, with the rationale to maintain uterine perfusion pressure and thereby uterine blood flow.Evidence for this strategy during general anaesthesia for nonobstetric surgery is absent.We investigated the effects of treating anaesthesia-induced hypotension with noradrenaline on the brain development of rabbit foetuses, of mothers subjected to general anaesthesia for nonobstetric surgery.We hypothesised that treatment of maternal hypotension would improve foetal outcomes.Neuron densities were similar but significantly less foetal survival, impaired neurobehaviour and less proliferation were observed after treat...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%