Maternal and fetal effects of laparoscopic insufflation in the gravid baboon

Abstract Study Objective. To test the hypothesis that intraabdominal pressures (IAP) associated with abdominal insufflation for laparoscopic procedures can alter pulmonary and hemodynamic values in the pregnant baboon and hemodynamic values in the fetus. Design. A descriptive physiologic study. Setting. Animal research facility at Scott and White Memorial Hospital, Temple, TX. Participants. Four pregnant baboons at 120±7 days' gestation. Interventions. The baboons underwent general anesthesia, Swan-Ganz and arterial catheter placement, and abdominal insufflation at 10 and 20 mm Hg IAP for 20-minute intervals at each pressure. The following end points were measured: maternal heart rate (MHR), mean arterial pressure (MAP), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressures (PAP), central venous pressure (CVP), systemic vascular resistance (SVR), ventilator rate (VR), oxygen saturation, and end-tidal carbon dioxide (CO 2). Fetal heart rate and fetal growth values were measured, and umbilical artery Doppler flow studies were performed. Measurements and Main Results. The PCWP (p