ANESTHETIC MANAGEMENT OF EX UTERO INTRAPARTUM TREATMENT (EXIT) AND FETAL SURGERY

Course overview

IN RECENT YEARS, THE SIGNIFICANT ADVANCEMENT IN IMAGING TECHNIQUES HAS LED TO THE EARLY AND DETAILED DIAGNOSES OF FETAL ABNORMALITIES IN UTERO. SOME OF THESE CONDITIONS MAY RESULT IN SIGNIFICANT IRREVERSIBLE ORGAN DAMAGE OR EVEN FETAL DEATH. SURGICAL INTERVENTION IS REQUIRED TO CORRECT THESE ABNORMALITIES WHEN THE FETUS IS STILL IN UTERO DURING MID-GESTATION OR IMMEDIATELY AFTER DELIVERY WHEN THE FETUS IS STILL ON PLACENTAL CIRCULATION (EXIT: EX UTERO INTRAPARTUM TREATMENT PROCEDURE). THESE PROCEDURES POSE A SPECIAL CHALLENGE TO THE ANESTHESIOLOGIST, HAVING TO CONSIDER THE UNIQUE MATERNAL PHYSIOLOGY AND FETAL PHYSIOLOGY. THIS ARTICLE REVIEWS THE ROLE PLAYED BY ANESTHESIOLOGISTS AS PART OF THE INTERPROFESSIONAL MANAGEMENT OF FETAL SURGERIES AND PROVIDES A BRIEF OVERVIEW OF THE ANESTHETIC MANAGEMENT OF VARIOUS FETAL SURGERIES.