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 (...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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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. |
format | Online Article Text |
id | pubmed-10034931 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
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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