Fukuda Kenji, Masuoka Jun, Takada Shigeki, Katsuragi Shinji, Ikeda Tomoaki, Iihara Koji
Department of Neurosurgery, National Cerebral and Cardiovascular Center.
Neurol Med Chir (Tokyo). 2014;54(10):819-23. doi: 10.2176/nmc.tn.2013-0359. Epub 2014 Apr 23.
We report two methods of intraoperative fetal heart rate (FHR) monitoring in cases of cerebral arteriovenous malformation surgery during pregnancy. In one case in her third trimester, cardiotocography was used. In another case in her second trimester, ultrasound sonography was used, with a transesophageal echo probe attached to her lower abdomen. Especially, the transesophageal echo probe was useful because of the advantages of being flexible and easy to attach to the mother's lower abdomen comparing with the usual doppler ultrasound probe. In both cases, the surgery was successfully performed and FHR was monitored safely and stably. The use of intraoperative FHR monitoring provides information about the influence of induced maternal hypotension and unexpected bleeding on fetus during surgery. These monitoring techniques would be especially emphasized in cerebrovascular surgery for the safe management of both mother and fetus.
我们报告了两种在孕期脑动静脉畸形手术中进行术中胎儿心率（FHR）监测的方法。在一名孕晚期的病例中，使用了胎心监护仪。在另一名孕中期的病例中，使用了超声检查，并将经食管超声探头附着于其下腹部。特别是，经食管超声探头很有用，因为与普通多普勒超声探头相比，它具有灵活且易于附着于母亲下腹部的优点。在这两个病例中，手术均成功进行，并且FHR得到了安全稳定的监测。术中FHR监测的应用提供了有关手术期间诱导性母体低血压和意外出血对胎儿影响的信息。这些监测技术在脑血管手术中对于母婴的安全管理将尤为重要。
