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Foetal surgery: Anaesthetic implications and strategic management

Intrauterine surgery is being performed with increasing frequency. Correction of foetal anomalies in utero can result in normal growth of foetus and a healthier baby at delivery. Intrauterine surgery can also improve the survival of babies who would have otherwise died at delivery, or in the neonata...

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Autores principales: Kodali, Bhavani Shankar, Bharadwaj, Shobana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144553/
https://www.ncbi.nlm.nih.gov/pubmed/30237598
http://dx.doi.org/10.4103/ija.IJA_551_18
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author Kodali, Bhavani Shankar
Bharadwaj, Shobana
author_facet Kodali, Bhavani Shankar
Bharadwaj, Shobana
author_sort Kodali, Bhavani Shankar
collection PubMed
description Intrauterine surgery is being performed with increasing frequency. Correction of foetal anomalies in utero can result in normal growth of foetus and a healthier baby at delivery. Intrauterine surgery can also improve the survival of babies who would have otherwise died at delivery, or in the neonatal period. There are three commonly used approaches to correct foetal anomalies: open surgery, where the foetus is exposed through hysterotomy; percutaneous approach, where needle or foetoscope is inserted through the abdominal wall and the uterine wall; finally, ex utero intrapartum treatment (EXIT) surgery, where the intervention is performed on the baby before terminating the maternal umbilical support to the baby. Anaesthetic management of the mother and the foetus requires good understanding of maternal physiology, foetal physiology, and pharmacological and surgical implications to the foetus. Uterine relaxation is a critical requisite for open foetal procedures and EXIT procedures. General anaesthesia and/or regional anaesthesia can be used successfully depending on the nature of foetal intervention. Foetal surgery poses complications not only to the foetus but also to the mother. Therefore, the decision for undertaking foetal surgery should always consider the risk to the mother versus benefit to the foetus.
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spelling pubmed-61445532018-09-20 Foetal surgery: Anaesthetic implications and strategic management Kodali, Bhavani Shankar Bharadwaj, Shobana Indian J Anaesth Review Article Intrauterine surgery is being performed with increasing frequency. Correction of foetal anomalies in utero can result in normal growth of foetus and a healthier baby at delivery. Intrauterine surgery can also improve the survival of babies who would have otherwise died at delivery, or in the neonatal period. There are three commonly used approaches to correct foetal anomalies: open surgery, where the foetus is exposed through hysterotomy; percutaneous approach, where needle or foetoscope is inserted through the abdominal wall and the uterine wall; finally, ex utero intrapartum treatment (EXIT) surgery, where the intervention is performed on the baby before terminating the maternal umbilical support to the baby. Anaesthetic management of the mother and the foetus requires good understanding of maternal physiology, foetal physiology, and pharmacological and surgical implications to the foetus. Uterine relaxation is a critical requisite for open foetal procedures and EXIT procedures. General anaesthesia and/or regional anaesthesia can be used successfully depending on the nature of foetal intervention. Foetal surgery poses complications not only to the foetus but also to the mother. Therefore, the decision for undertaking foetal surgery should always consider the risk to the mother versus benefit to the foetus. Medknow Publications & Media Pvt Ltd 2018-09 /pmc/articles/PMC6144553/ /pubmed/30237598 http://dx.doi.org/10.4103/ija.IJA_551_18 Text en Copyright: © 2018 Indian Journal of Anaesthesia http://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 Review Article
Kodali, Bhavani Shankar
Bharadwaj, Shobana
Foetal surgery: Anaesthetic implications and strategic management
title Foetal surgery: Anaesthetic implications and strategic management
title_full Foetal surgery: Anaesthetic implications and strategic management
title_fullStr Foetal surgery: Anaesthetic implications and strategic management
title_full_unstemmed Foetal surgery: Anaesthetic implications and strategic management
title_short Foetal surgery: Anaesthetic implications and strategic management
title_sort foetal surgery: anaesthetic implications and strategic management
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144553/
https://www.ncbi.nlm.nih.gov/pubmed/30237598
http://dx.doi.org/10.4103/ija.IJA_551_18
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