Recent advances in anaesthesia for intrauterine and foetal surgery

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 (...

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Autores principales: Nath, Gita, Subrahmanyam, M, Jayanthi, R, Singh, Ranju, Ramesh, S, Ahuja, Vanita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034931/
https://www.ncbi.nlm.nih.gov/pubmed/36970490
http://dx.doi.org/10.4103/ija.ija_964_22
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author Nath, Gita
Subrahmanyam, M
Jayanthi, R
Singh, Ranju
Ramesh, S
Ahuja, Vanita
author_facet Nath, Gita
Subrahmanyam, M
Jayanthi, R
Singh, Ranju
Ramesh, S
Ahuja, Vanita
author_sort Nath, Gita
collection PubMed
description 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.
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spelling pubmed-100349312023-03-24 Recent advances in anaesthesia for intrauterine and foetal surgery Nath, Gita Subrahmanyam, M Jayanthi, R Singh, Ranju Ramesh, S Ahuja, Vanita Indian J Anaesth Special Article 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. Wolters Kluwer - Medknow 2023-01 2023-01-21 /pmc/articles/PMC10034931/ /pubmed/36970490 http://dx.doi.org/10.4103/ija.ija_964_22 Text en Copyright: © 2023 Indian Journal of Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Special Article
Nath, Gita
Subrahmanyam, M
Jayanthi, R
Singh, Ranju
Ramesh, S
Ahuja, Vanita
Recent advances in anaesthesia for intrauterine and foetal surgery
title Recent advances in anaesthesia for intrauterine and foetal surgery
title_full Recent advances in anaesthesia for intrauterine and foetal surgery
title_fullStr Recent advances in anaesthesia for intrauterine and foetal surgery
title_full_unstemmed Recent advances in anaesthesia for intrauterine and foetal surgery
title_short Recent advances in anaesthesia for intrauterine and foetal surgery
title_sort recent advances in anaesthesia for intrauterine and foetal surgery
topic Special Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034931/
https://www.ncbi.nlm.nih.gov/pubmed/36970490
http://dx.doi.org/10.4103/ija.ija_964_22
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