Department of Anesthesiology and Pain Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States.
Semin Pediatr Surg. 2024 Oct;33(5):151455. doi: 10.1016/j.sempedsurg.2024.151455. Epub 2024 Oct 9.
Fetal therapy is a well-established but rapidly evolving field discipline. Fetal interventions require a multidisciplinary team approach that emphasizes collaboration and communication. The success of a fetal therapy program relies on the availability of a comprehensive obstetric and neonatal care team, support services, and advanced imaging. Technological advancements in prenatal fetal imaging and genetic diagnosis have improved our understanding of various fetal anomalies. Surgical techniques and anesthetic management have also advanced, leading to better outcomes. Fetal anesthesia presents unique challenges as it involves managing both the mother and the fetus. Anesthetic management focuses on ensuring maternal safety and comfort, maintaining adequate uteroplacental perfusion, optimizing surgical conditions, and minimizing risks for both the mother and the fetus. This article reviews current anesthesia practices for fetal surgery, highlighting recent advances and future directions.
胎儿治疗是一门成熟但快速发展的学科。胎儿干预需要多学科团队方法，强调协作和沟通。胎儿治疗计划的成功依赖于全面的产科和新生儿护理团队、支持服务以及先进的影像学技术。产前胎儿影像学和基因诊断技术的进步提高了我们对各种胎儿畸形的认识。手术技术和麻醉管理也得到了改进，从而带来了更好的结果。胎儿麻醉具有独特的挑战，因为它涉及到对母亲和胎儿的管理。麻醉管理的重点是确保母亲的安全和舒适，维持足够的胎盘灌注，优化手术条件，并最大限度地降低母亲和胎儿的风险。本文回顾了胎儿手术的当前麻醉实践，强调了最近的进展和未来的方向。
