Department of Development and Regeneration, Cluster Woman and Child, Group Biomedical Sciences, KU Leuven, Belgium.
Clinical Department Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
Prenat Diagn. 2021 Aug;41(9):1164-1170. doi: 10.1002/pd.5954. Epub 2021 May 16.
During fetal surgery, fetuses receive medication (atropine-fentanyl-curare) to prevent fetal pain, movement and bradycardia. Although essential there has been no detailed review of potential side effects. Herein we aimed to assess the effects of this medication cocktail on fetal brain development in a rabbit model.
Pregnant does underwent laparotomy at 28 days of gestation. Two pups of each horn were randomized to an ultrasound guided injection with medication (atropine-cisatracurium-fentanyl, as clinically used) or saline (sham). The third pup was used as control. At term, does were delivered by cesarean. Outcome measures were neonatal biometry, neuromotoric functioning and neuro-histology (neuron density, synaptic density and proliferation).
Maternal vital parameters remained stable during surgery. Fetal heart rates did not differ before and after injection, and were comparable for the three groups. At birth, neonatal body weights and brain-to-body weight ratios were also comparable. Both motor and sensory neurobehavioral scores were comparable. There were no differences in neuron density or proliferation. Sham pups, had a lower synaptic density in the hippocampus as compared to the medication group, however there was no difference in the other brain areas.
In the rabbit model, fetal medication does not appear to lead to short-term neurocognitive effects.
在胎儿手术中，胎儿会接受药物（阿托品-芬太尼-箭毒）治疗，以防止胎儿疼痛、运动和心动过缓。虽然这是必要的，但尚未详细评估这种药物组合的潜在副作用。在此，我们旨在评估该药物鸡尾酒对兔模型胎儿大脑发育的影响。
妊娠母兔在妊娠 28 天行剖腹术。每侧角的两只幼兔随机接受超声引导下的药物（阿托品顺式阿曲库铵-芬太尼，如临床使用）或生理盐水（假手术）注射。第三只幼兔作为对照。足月时，通过剖宫产分娩母兔。测量新生儿的生物计量学、神经运动功能和神经组织学（神经元密度、突触密度和增殖）。
手术过程中母兔的生命体征保持稳定。胎儿心率在注射前后无差异，三组间比较无差异。出生时，新生儿体重和脑体比也无差异。运动和感觉神经行为评分也无差异。神经元密度或增殖无差异。与药物组相比，假手术组幼兔海马区的突触密度较低，但在其他脑区无差异。
在兔模型中，胎儿药物治疗似乎不会导致短期神经认知影响。
