Anesthesiological provision of open fetal surgery

Abstract

Fetal surgery is a rapidly growing feld of medicine. Anesthetic provision of fetal operations is developing together with progressing surgical techniques. The fundamentals of the physiology of a pregnant woman and a fetus are considered. The features of transplacental drug transfer are described. The mechanisms of uteroplacental and fetoplacental interactions have been analyzed. The contemporary data are presented that allow judging about the method of choice and approach to anesthesia in open fetal surgery. Reviewed scientifc information, including reviews of recent years and randomized trials The perspective of an anesthesiologist is shown, involved in open fetal surgery, including perioperative and intraoperative management of two high-risk patients, i.e. a pregnant woman and fetus undergoing surgical intervention at the same time. Postoperative management of patient data. The impossibility of carrying out such operations without the well-coordinated work of a large multidisciplinary team of specialists is noted.