Intraoperative myometry relaxation in anesthetic support of intrauterine correction of spina bifida in the fetus via open access

Objective. To improve and optimize a comprehensive approach to anesthetic support and tocolytic therapy following open correction of Spina bifida in the fetus. Material and methods. A prospective randomized comparative study included patients in the second trimester of pregnancy with congenital malformations of central nervous system of the fetus (myelomeningocele, ventriculomegaly, Arnold—Chiari malformation type 2). All patients underwent combined anesthesia (neuroaxial+general anesthesia). In the 1st group, 25% magnesium sulfate solution 16 ml was additionally administered for tocolysis for 15 min before surgery followed by 25% magnesium sulfate solution 4 ml/h throughout surgery. In the 2nd group, atosiban was administered at a rate of 300 μg/min, and nitroglycerin was administered intravenously at a rate of 0.2—0.3 μg/kg/min intraoperatively. Results. Lower dose of inhalation anesthetic in the 2nd group did not increase the frequency of intraoperative myometrial contractions. On the contrary, there was significant difference in registration of increased intraoperative myometrial tone in the 1st group (55% vs. 5%, p