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Year : 2009  |  Volume : 53  |  Issue : 5  |  Page : 554-559

Anaesthesia for Fetal Surgeries

Professor, Department of Anesthesiology & Intensive care, Maulana Azad Medical college, New Delhi, India

Correspondence Address:
Kirti N Saxena
B-302, Geetanjali Apartments, Vikas Marg Extension, New Delhi- 110092
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Source of Support: None, Conflict of Interest: None

PMID: 20640105

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The concept of the fetus as a patient has evolved from prenatal diagnosis and serial observation of fetuses with anatomical abnormalities.. Surgical intervention is considered when a fetus presents with a congenital lesion that can compromise or disturb vital function or cause severe postnatal morbidity. Hydronephrosis, saccrococcygeal ter­atoma, hydrocephalus, meningomyelocoele and diaphragmatic hernia are some of the defects that can be diagnosed by imaging and are amenable to intervention. The combination of underdeveloped organ function and usually life-threatening congenital malformation places the fetus at a considerable risk. Fetal surgery also leads to enhanced surgical and anaesthetic risk in the mother including haemon - hage, infection, airway difficulties and amniotic fluid embolism. There are 3 basic types of surgical interventions: 1.Ex utero intrapartum treatment(EHIT), 2.Midgestation open procedures, 3.Minimally invasive midgestation procedures. These procedures require many manipulations and moni­toring in both the mother and the unborn fetus.

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