Spiral electrode for continuous fetal heart rate monitoring during in-utero myelomeningocele repair

Int J Obstet Anesth. 2020 Nov:44:16-19. doi: 10.1016/j.ijoa.2020.06.004. Epub 2020 Jun 27.

Abstract

Continuous fetal hemodynamic monitoring during in-utero surgery is desirable, but it is often not feasible without intermittent interruption. We report the use of a fetal spiral electrode for continuous heart rate monitoring during fetal myelomeningocele repair. Fetal echocardiography and a fetal spiral electrode were used to monitor fetal heart rate during in-utero repair at 25 weeks' gestation. We observed good agreement between echocardiographic and spiral electrode heart rate measurements. Using the Bland-Altman approach, the mean (SD) difference between measurements was 1.8 (3.5) beats per minute with limits of agreement of -5.3 to 8.8 beats per minute. This case illuminates a potential role for a fetal spiral electrode as a real-time adjunct in fetal interventions.

Keywords: Fetal anesthesia; Fetal spiral electrode; Fetal surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Echocardiography / methods*
  • Electrodes
  • Female
  • Fetal Monitoring / instrumentation*
  • Fetal Monitoring / methods*
  • Heart Rate, Fetal / physiology*
  • Humans
  • Meningomyelocele / diagnostic imaging
  • Meningomyelocele / embryology*
  • Meningomyelocele / surgery*
  • Pregnancy
  • Ultrasonography, Prenatal / methods