THE INCIDENCE AND SPECTRUM OF NEUROLOGICAL INJURY AFTER OPEN FETAL SURGERY

A preterm infant's immature brain is susceptible to both anoxic and he morrhagic injury during periods of physiological stress, The advent of in utero surgery has created a new population of premature patients a t risk for central nervous system (CNS) injury. The aim of this study was to evaluate the frequency and nature of CNS injuries in fetal surg ical patients. Of 33 fetuses with known neurological outcome after fet al surgery, CNS injuries were identified in seven (21%). Of the seven, four had significant episodes of fetal bradycardia (3) or neonatal hy potension (1), which suggests that asphyxia contributed to the neurolo gical injury. The CNS injuries in the other three patients occurred un expectedly and without associated signs of fetal distress. The authors speculate that these injuries may have been caused by sudden fluxes i n cerebral blood flow, induced by maternal hypoxia (1) or by maternall y administered tocolytic drugs (2) used to treat postoperative preterm labor. Copyright (C) 1995 by W.B. Saunders Company