Application of near-infrared spectroscopy during fetal cardiac surgery.

Background: Near-infrared spectroscopy (NIRS) has been shown to provide reliable noninvasive monitoring of regional oxygenation in a variety of clinical settings. We set out to test its feasibility as a monitor of fetal and placental oxygenation during fetal cardiac surgery.

Materials And Methods: Six ovine fetuses from 98-110 ds gestation were placed on fetal bypass for 30 min and followed post-bypass for 2 h.

Fetal stress response to fetal cardiac surgery.

Background: A deleterious fetal stress response, although not fully elucidated, may account for poor outcomes after experimental fetal cardiac surgery. We set out to characterize this fetal stress response and its potential role in placental dysfunction.

Methods: Fifteen ovine fetuses at gestational day 100 to 114 were placed on extracorporeal support for 30 minutes and were then followed 2 hours after cardiopulmonary bypass.

A simple solution is "prime" for fetal cardiopulmonary bypass.

Worsening fetal gas exchange is the hallmark of frequently observed placental dysfunction after fetal bypass. Several factors influence this pathophysiology, but the optimal prime constituents for fetal bypass have yet to be defined. Calcium and sodium bicarbonate are frequently added to prime solutions for adjustments toward physiologic values.