Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Paediatr Anaesth. 2021 Mar;31(3):275-281. doi: 10.1111/pan.14120. Epub 2021 Feb 11.
A wide range of fetal interventions are being performed worldwide to save the fetus's life, prevent permanent fetal organ damage, and allow a successful transition to extrauterine life. However, these are invasive procedures and can be associated with serious complications. This article focuses on promoting a culture of safety by highlighting five common error traps while anesthetizing patients for fetal interventions. They include failure to preserve uteroplacental perfusion and gas exchange, failure to achieve adequate uterine relaxation prior to hysterotomy, failure to monitor the fetus and prepare for fetal/neonatal resuscitation, failure to prepare for maternal hemorrhage, and failure to promptly treat uterine atony. Practical tips for avoiding these serious complications will also be discussed.
在全世界范围内，广泛采用各种胎儿干预措施来挽救胎儿生命、防止胎儿永久性器官损伤，并为胎儿向宫外生活的成功过渡做好准备。然而，这些都是有创性的操作，可能会导致严重的并发症。本文通过强调在为胎儿干预进行麻醉时的五个常见错误陷阱，聚焦于促进安全文化。这些错误陷阱包括未能维持子宫胎盘灌注和气体交换、未能在子宫切开前充分松弛子宫、未能监测胎儿并为胎儿/新生儿复苏做好准备、未能为产妇出血做好准备以及未能及时治疗子宫收缩乏力。还将讨论避免这些严重并发症的实用技巧。
