الفهرس 
PHYSIOLOGICAL CONSIDERATIONSOnly 14 pages are availabe for public view
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Abstract
A
nesthesia for fetal surgery is becoming an exciting new area of practice for anesthesiologists. By constantly refining anesthetic techniques and readdressing important issues such as tocolysis, the anesthesiologist can not only play a vital role in the care of fetal surgery patients today, but also help to establish improvements in care and research in these patients for years to come.
Anesthesia for fetal surgery involves two patients simultaneously, the mother and the fetus. Anesthesia for fetal surgery differs from that for maternal surgery (e.g. Caesarean sections, cholecystectomy in the parturient) and fetal therapy (e.g. amniotic fluid reduction).
In fetal surgery, the fetus and mother are both active recipients of surgery whereas, in maternal surgery, the mother is an active recipient while the fetus is a bystander. In fetal therapy, the mother is a bystander while the fetus is an active recipient of therapy. The distinction will likely become more important as the mechanism of labour becomes better understood. Fetal surgery consists of open or minimally invasive procedures. Open procedures require a hysterotomy on the mother and major airway, thoracic, cardiovascular and neurological procedures on the fetus. Minimally invasive fetal procedures include insertion of stents or shunts, occlusion or coagulation of fetoplacental structures, and transfusion of medications or blood products directly into the fetus. These procedures may be performed with sedation, regional anaesthesia or general anaesthesia, depending on maternal and fetal factors.