Anesthesia for Fetal Surgery and Fetal Procedures

Clin Perinatol. 2019 Dec;46(4):801-816. doi: 10.1016/j.clp.2019.08.011. Epub 2019 Aug 14.

Abstract

Advances in imaging and technique have pushed the boundaries of the types of surgical interventions available to fetuses with congenital and developmental abnormalities. This review focuses on fundamental aspects of fetal anesthesia, including the physiologic changes of pregnancy, uteroplacental perfusion, and fetal physiology. We discuss the types of fetal surgeries and procedures currently being performed and discuss the specific anesthetic approaches to different categories of fetal surgeries. We also discuss ethical aspects of fetal surgery and anesthesia.

Keywords: Congenital defects; Fetal anesthesia; Fetal surgery.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Anesthesia, Conduction / methods*
  • Anesthesia, General / methods*
  • Anesthetics / therapeutic use*
  • Cesarean Section / methods
  • Female
  • Fetal Diseases / surgery*
  • Fetal Therapies / ethics
  • Fetal Therapies / methods*
  • Fetal Viability
  • Fetoscopy / methods
  • Fetus / surgery*
  • Gestational Age
  • Humans
  • Injections, Intramuscular
  • Minimally Invasive Surgical Procedures / methods
  • Needles
  • Neuromuscular Blocking Agents / therapeutic use
  • Placental Circulation / physiology
  • Pregnancy / physiology
  • Surgery, Computer-Assisted

Substances

  • Analgesics, Opioid
  • Anesthetics
  • Neuromuscular Blocking Agents