Impact of partial amniotic carbon dioxide insufflation (<scp>PACI</scp>) on middle cerebral artery blood flow in mid‐gestation human fetuses undergoing fetoscopic surgery for spina bifida aperta

Kohl, Thomas

doi:10.1002/uog.15761

Cited by 7 publications

(2 citation statements)

References 11 publications

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“…In contrast to our technique of amnio distension by amnioinfusion and therefore working in an under-water environment, other authors suggest the use of partial amniotic carbon dioxide insufflation (PACI) for amnio distension and thus much better instrumentation of the fetus. The consequences of both techniques onto the uterus and chorioamniotic membranes have to be directly compared in animal studies [84,85].…”

Section: Fetoscopic Coveringmentioning

confidence: 99%

Fetal Surgery for Gastroschisis—A Review with Emphasis on Minimally Invasive Procedures

et al. 2022

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(1) Background: The morbidity of gastroschisis is defined by exposure of unprotected intestines to the amniotic fluid leading to inflammatory damage and consecutive intestinal dysmotility, the viscero-abdominal disproportion which results in an abdomen too small to incorporate the herniated and often swollen intestine, and by associated pathologies, such as in complex gastroschisis. To prevent intestinal damage and to provide for growth of the abdominal cavity, fetal interventions such as amnio exchange, gastroschisis repair or covering have been evaluated in several animal models and human trials. This review aims to evaluate the reported techniques for the fetal treatment of gastroschisis by focusing on minimally invasive procedures. (2) Methods: We conducted a systematic database search, quality assessment and analyzed relevant articles which evaluate or describe surgical techniques for the prenatal surgical management of gastroschisis in animal models or human application. (3) Results: Of 96 identified reports, 42 eligible studies were included. Fetal interventions for gastroschisis in humans are only reported for EXIT procedures and amnio exchange. In animal models, particularly in the fetal sheep model, several techniques of open or minimally invasive repair of gastroschisis or covering the intestine have been described, with fetoscopic covering being the most encouraging. (4) Discussion: Although some promising minimally invasive techniques have been demonstrated in human application and animal models, most of them are still associated with relevant fetal morbidity and mortality and barely appear to be currently applicable in humans. Further research on specific procedures, instruments and materials is needed before any human application.

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Section: Fetoscopic Coveringmentioning

confidence: 99%

Fetal Surgery for Gastroschisis—A Review with Emphasis on Minimally Invasive Procedures

et al. 2022

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“…An issue that has raised concern extensively is the possible occurrence of fetal acidosis during fetoscopic surgery using partial CO 2 insufflation of the amniotic cavity. Kohl and colleagues have addressed this issue in sheep and did not find evidence of histological damage in the fetal brain after CO 2 insufflation during fetoscopy.…”

Section: Introductionmentioning

confidence: 99%