{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:37:21Z","timestamp":1787009841798,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Use of high-dose inhalational anesthesia during open fetal surgery may induce maternal\u2013fetal hemodynamic instability and fetal myocardial depression. The authors\u2019 preliminary human retrospective study demonstrated less fetal bradycardia and left ventricular systolic dysfunction with lower dose desflurane supplemented with propofol and remifentanil IV anesthesia (SIVA). In this animal study, the authors compare maternal\u2013fetal effects of high-dose desflurane anesthesia (HD-DES) and SIVA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Of 26 instrumented midgestational ewes, data from 11 animals exposed to both SIVA and HD-DES in random sequences and six animals exposed to HD-DES while maternal normotension was maintained were analyzed. Maternal electroencephalography was used to guide comparable depths of anesthesia in both techniques. Hemodynamic parameters, blood gas, and fetal cardiac function from echocardiography were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Compared with SIVA, HD-DES resulted in significant maternal hypotension (mean arterial pressure difference, 19.53 mmHg; 95% CI, 17.6\u201321.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001), fetal acidosis (pH 7.11\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      . 7.24 at 150 min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and decreased uterine blood flow. In the HD-DES group with maternal normotension, uterine blood flow still declined and fetal acidosis persisted, with no statistically significant difference from the group exposed to HD-DES that had maternal hypotension. There was no statistically significant difference in fetal cardiac function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In sheep, SIVA affects maternal hemodynamics less and provides better fetal acid\/base status than high-dose desflurane. Fetal echocardiography did not reflect myocardial dysfunction in this model.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/aln.0b013e318283c954","type":"journal-article","created":{"date-parts":[[2013,1,22]],"date-time":"2013-01-22T03:07:13Z","timestamp":1358824033000},"page":"796-808","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":30,"title":["Anesthetic Techniques for Fetal Surgery"],"prefix":"10.1097","volume":"118","author":[{"given":"Pornswan","family":"Ngamprasertwong","sequence":"first","affiliation":[{"name":"Assistant Professor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik C.","family":"Michelfelder","sequence":"additional","affiliation":[{"name":"Associate Professor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahriar","family":"Arbabi","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Suk","family":"Choi","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anesthesiology and Pain Medicine, Jeju National University Medical School, Jeju-si, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Statile","sequence":"additional","affiliation":[{"name":"Cardiology Fellow, Division of Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Ding","sequence":"additional","affiliation":[{"name":"Assistant Professor, Division of Biostatistics and Epidemiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Boat","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anesthesiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirooz","family":"Eghtesady","sequence":"additional","affiliation":[{"name":"Professor, Division of Cardiothoracic Surgery, St. Louis Children\u2019s Hospital, Saint Louis, Missouri."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Holland","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Neurology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senthilkumar","family":"Sadhasivam","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anesthesiology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20241219","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1014379","article-title":"MOMS Investigators: A randomized trial of prenatal versus postnatal repair of 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