Anesthesia-Related Factors Associated with Preterm Labor and Delivery after Open Fetal Surgery

Area of Science:

• Maternal-fetal medicine
• Anesthesiology
• Surgical innovation

Background:

• Fetal surgery, like meningomyelocele repair, offers significant clinical benefits by reducing long-term infant morbidity.
• However, these procedures increase the risk of preterm labor and delivery for the mother.
• While surgical factors are known, anesthesia-related factors influencing maternal complications remain unclear.

Purpose of the Study:

• To investigate the impact of perioperative anesthetic management on maternal complications after in utero surgery.
• To identify specific anesthetic or hemodynamic factors associated with adverse maternal outcomes.

Main Methods:

• Retrospective chart review of anesthetic management for mothers undergoing open or fetoscopic myelomeningocele repair.
• Data collected from 2011 to 2015 at Texas Children's Fetal Center®.
• Analysis focused on perioperative anesthetic details and maternal outcomes.

Main Results:

• Forty-six women were included in the study.
• Elevated postoperative maternal heart rate was linked to a higher likelihood of preterm labor, but not preterm delivery.
• Nulliparous patients and those with lower intraoperative diastolic pressure had increased odds of preterm delivery.

Conclusions:

• Confirms the association between nulliparity and preterm delivery.
• Emphasizes the critical role of maintaining stable perioperative hemodynamics.
• Highlights the importance of vigilant anesthetic management during and after in utero surgery to mitigate maternal risks.