Recent advances in anaesthesia for intrauterine and foetal surgery

Autor: Gita Nath, M Subrahmanyam, R Jayanthi, Ranju Singh, S Ramesh, Vanita Ahuja
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Indian Journal of Anaesthesia, Vol 67, Iss 1, Pp 11-18 (2023)
Druh dokumentu: article
ISSN: 0019-5049
0976-2817
DOI: 10.4103/ija.ija_964_22
Popis: Advances in prenatal diagnostic techniques have enabled early detection of potentially correctable foetal anomalies. Here, we summarise recent developments in anaesthesia for foetal surgery. Types of foetal surgery include minimally invasive, open mid-gestational and ex-utero intrapartum treatment (EXIT) procedures. Foetoscopic surgery avoids hysterotomy, with risk of uterine dehiscence, preserving the possibility of subsequent vaginal delivery. Minimally invasive procedures are performed under local or regional anaesthesia; open or EXIT procedures are usually done under general anaesthesia. Requirements include maintenance of uteroplacental blood flow, and uterine relaxation to prevent placental separation and premature labour. Foetal requirements include monitoring of well-being, providing analgesia and immobility. EXIT procedures require maintenance of placental circulation till the airway is secured, requiring multidisciplinary involvement. Here, the uterine tone must return after baby delivery to prevent major maternal haemorrhage. The anaesthesiologist plays a crucial role in maintaining maternal and foetal homeostasis and optimising surgical conditions.
Databáze: Directory of Open Access Journals
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