RESUMEN
While instituting a new program in fetoscopy, the authors explored the effects of sedation with meperidine (Demerol) and promethazine HCl (Phenergan) during fetoscopy conducted on 10 mothers at 14 to 18 weeks' gestation. Each received 100 mg of meperidine and 50 mg of promethazine HCl approximately 30 minutes before the procedure. In 3 instances, a repeat half-dose injection was made at 30 minutes for adequate analgesia. Sex of the fetus was determined accurately in 9 instances. In 9 of 10 cases, visualization was satisfactory; technical problems in 1 case precluded visualization. Complications included 2 superficial fetal limb hematomas and 2 instances of minimal fetal bleeding from an unknown site. Three patients required perforation of anterior placentas. Amniotic fluid was invariably clear but became progressively turbid. Sedation allowed a longer period for clear amniotic fluid by decreasing fetal movements progressively over the first hour; fetal activity showed a prompt return thereafter. The clarity of the amniotic fluid was adversely influenced by external manipulation of the fetus. The authors conclude that sedation has obvious benefits for the mother and may facilitate evaluation of the fetus during fetoscopy.