Intrauterine resuscitation with fetal cardiocentesis during fetoscopic surgery

Francés, Sonia; Manrique, Susana; Munar, F.; Montferrer, N.; Muñoz, C.; Roigé, J.

doi:10.1016/j.ijoa.2010.06.003

Cited by 1 publication

(2 citation statements)

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“… Increase oxygen delivery to foetus Optimise maternal fraction of inspired oxygen (FiO 2 ) and ventilation Maintain maternal blood pressure – Left uterine displacement, vasopressors, fluids Improve uterine relaxation Check for placental abruption Post-placental measures Relieve cord compression, reposition foetus Increase uterine volume – infuse warm fluid Improve foetal cardiac function – injection of adrenaline or atropine into the foetal heart (cardiocentesis) or into umbilical cord (cordocentesis), foetal blood transfusion, foetal chest compressions[ 14 ] …”

Section: Anaesthesia Considerations For Foetal Surgerymentioning

confidence: 99%

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Recent advances in anaesthesia for intrauterine and foetal surgery

Nath

Subrahmanyam

Jayanthi

et al. 2023

Indian Journal of Anaesthesia

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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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Section: Anaesthesia Considerations For Foetal Surgerymentioning

confidence: 99%

“… Relieve cord compression, reposition foetus Increase uterine volume – infuse warm fluid Improve foetal cardiac function – injection of adrenaline or atropine into the foetal heart (cardiocentesis) or into umbilical cord (cordocentesis), foetal blood transfusion, foetal chest compressions[ 14 ] …”

Section: Anaesthesia Considerations For Foetal Surgerymentioning

confidence: 99%