title: Intravenous pancuronium bromide for fetal neuromuscular blockade during intrauterine transfusion for red-cell alloimmunization.
abstract: Intravenous pancuronium bromide was administered into the umbilical cord by funipuncture to effect temporary fetal paralysis. Neuromuscular blockade was achieved in 12 fetuses undergoing a total of 34 intrauterine procedures for the treatment of severe red-cell alloimmunization. The same initial dose of 0.2 mg/kg fetal weight estimated by ultrasound was used in all cases, but anemic fetuses did not resume movement for prolonged periods. A relationship among fetal hematocrit, adjusted dose, and duration of paralysis was described by the equation: Duration (hours) = 5.24 + 10.30 adjusted dose (mg/kg) - 0.16 hematocrit (%) (R2 = 0.49; P less than .001). Intravenous pancuronium was found to be a safe and effective method for cessation of fetal movement during intrauterine procedures.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors.forename: K J
authors.initials: KJ
authors.lastname: Moise
authors.forename: R L
authors.initials: RL
authors.lastname: Deter
authors.forename: B
authors.initials: B
authors.lastname: Kirshon
authors.forename: K
authors.initials: K
authors.lastname: Adam
authors.forename: D E
authors.initials: DE
authors.lastname: Patton
authors.forename: R J
authors.initials: RJ
authors.lastname: Carpenter
mesh_terms: D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000628:therapy*; D017707:Erythrocyte Transfusion; D005324:Fetal Movement / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D007275:Injections, Intravenous; D009469:Neuromuscular Junction / Q000187:drug effects*; D010197:Pancuronium / Q000008:administration & dosage*; D014471:Umbilical Veins
chemical_list: D010197:Pancuronium