The use of pressure monitoring to standardize fetal arterial visualization

Abstract

H Shemshadi, RJ Rohrich, L Li, JB Robinson Jr. The use of pressure monitoring to standardize fetal arterial visualization. Can J Plast Surg 1996;4(3):161-164. The application of a new x-ray opaque postmortem perfusion system for the visualization of vascular structures in fetal models is presented. This new system allows pig fetus perfusion to be performed at pressures of less than 30 mmHg. At higher pressures, extravasations were observed in known weak spots in the fetal vasculature, and multiple perfusions at the same pressure exhibited similar patterns of extravasation (demonstrated at all pressures studied). Therefore this technique is controllable and predictable. It will allow determination of fetal vascular malformations which have been implicated as causes of many birth defects. Key Words: Anatomy, Birth detects, Fetus, Perfusion, VasculatureRecours à la surveillance de la tension pour normaliser la visualisation artérielle foetale RÉSUMÉ : L'application d'un nouveau système de perfusion post-mortem radio-opaque pour la visualisation des structures vasculaires dans des modèles foetaux est présentée ici. Le nouveau système permet d'effectuer des perfusions chez des porcelets à des pressions de moins de 30 mm Hg. À des pressions plus élevées, on observait de l'extravasation en certains points faibles connus de l'appareil vasculaire foetal et les multiples perfusions à la même pression présentaient des modes similaires d'extravasation (démontrés à toutes les pressions étudiées). Par conséquent, cette technique peut être contrôlée et prévisible. Elle permet la détermination des malformations vasculaires foetales incriminées dans de nombreuses anomalies congénitales.Fetal anatomical vasculature has been extensively studied with respect to the differences in developmental stages (1), patterns of branches, number of branches and anatomical weak points (2). With the recent advances in fetal reconstructive surgery (3), one must not only have basic knowledge of fetal anatomy but must also correlate such knowledge with the physiological changes and pressure tolerances of the fetal vascular system before performing a surgical procedure aimed at correcting an intrauterine anomaly.This study attempted to standardize a method of fetal arterial vascularization at different perfusion pressures and observe any vascular extravasations that may have been caused by increases in perfusion pressure and that are not present in the intact fetus, and to visualize what points of the fetal vascular anatomy are most susceptible to this CAN