{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:09:55Z","timestamp":1773878995923,"version":"3.50.1"},"reference-count":60,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["NIHR\u2010RP\u20102014\u201004\u2010046"],"award-info":[{"award-number":["NIHR\u2010RP\u20102014\u201004\u2010046"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1S31720N"],"award-info":[{"award-number":["1S31720N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the safety of Partial\u2010Amniotic\u2010Insufflation\u2010of\u2010heated\u2010humidified\u2010CO<jats:sub>2<\/jats:sub> (hPACI) during fetoscopic spina bifida repair (fSB\u2010repair).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A simulated fSB\u2010repair through an exteriorized uterus under hPACI was performed in 100\u2010day fetal lambs (term\u00a0=\u00a0145\u00a0days) under a laboratory anesthesia protocol (<jats:italic>n<\/jats:italic>\u00a0=\u00a05; group 1) which is known to induce maternal\u2010fetal acidosis and hypercapnia. Since these may not occur clinically, we applied a clinical anesthesia protocol (<jats:italic>n<\/jats:italic>\u00a0=\u00a05; group 2), keeping maternal parameters within physiological conditions, that is, controlled maternal arterial carbon dioxide (CO2) pressure (pCO<jats:sub>2<\/jats:sub>\u00a0=\u00a030\u00a0mmHg), blood pressure (\u226567\u00a0mmHg), and temperature (37.1\u201339.8\u00b0C). Our superiority study used fetal pH as the primary outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to group 1, controlled anesthesia normalized fetal pH (7.23\u00a0\u00b1\u00a00.02 vs. 7.36\u00a0\u00b1\u00a00.02, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), pCO<jats:sub>2<\/jats:sub> (70.0\u00a0\u00b1\u00a09.1 vs. 43.0\u00a0\u00b1\u00a01.0\u00a0mmHg, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.011) and bicarbonate (27.8\u00a0\u00b1\u00a01.1 vs. 24.0\u00a0\u00b1\u00a00.9\u00a0mmol\/L, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.071) at baseline. It kept them within clinically acceptable limits (pH\u00a0\u2265\u00a07.23, pCO<jats:sub>2<\/jats:sub>\u00a0\u2264\u00a070\u00a0mmHg, bicarbonate\u00a0\u2264\u00a030\u00a0mm\/L) for \u2265120\u00a0min of hPACI as opposed to \u226430\u00a0min in group one. Fetal pO<jats:sub>2<\/jats:sub> and lactate were comparable between groups and generally within normal range. Fetal brain histology demonstrated fewer apoptotic cells and higher neuronal density in the prefrontal cortex in group two. There was no difference in fetal membrane inflammation, which was mild.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fetoscopic insufflation of heated\u2010humidified CO<jats:sub>2<\/jats:sub> during simulated fSB\u2010repair through an exteriorized uterus can be done safely under controlled anesthesia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6093","type":"journal-article","created":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T03:38:50Z","timestamp":1642217930000},"page":"180-191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fetoscopic insufflation of heated\u2010humidified carbon dioxide during simulated spina bifida repair is safe under controlled anesthesia in the fetal lamb"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7331-6354","authenticated-orcid":false,"given":"Luc","family":"Joyeux","sequence":"first","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Biomedical Sciences KU Leuven  Leuven Belgium"},{"name":"Center for Surgical Technologies Faculty of Medicine KU Leuven  Leuven Belgium"},{"name":"Department of Obstetrics\u00a0&amp; 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