abstract: Due to the responsibility for the mother and the unborn child, fetal surgery represents a challenging task for the anesthesiologist. Maternal changes during pregnancy have to be considered as well as the fetal physiology and the surgeon's needs. Main principles of the anesthesiological management of fetal surgery include the stabilization of the mean arterial pressure in order to preserve a sufficient placental blood flow, sustainment of an adequate oxygenation and ventilation as well as thorough temperature surveillance. Since the mothers are at risk for perioperative pulmonary edema, extended hemodynamic monitoring might be necessary. This article presents the principles of fetal surgery, informs about pregnancy-related changes in circulatory and respiratory physiology and contains anesthesiological considerations to this topic.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Schneck
authors.forename: Christian
authors.initials: C
authors.lastname: Koch
authors.forename: Christoph
authors.initials: C
authors.lastname: Arens
authors.forename: Rainer
authors.initials: R
authors.lastname: Schürg
authors.forename: Thomas
authors.initials: T
authors.lastname: Zajonz
authors.forename: Anastasiia
authors.initials: A
authors.lastname: Khaleeva
authors.forename: Thomas
authors.initials: T
authors.lastname: Kohl
authors.forename: Markus A
authors.initials: MA
authors.lastname: Weigand
authors.forename: Michael
authors.initials: M
authors.lastname: Sander
mesh_terms: D000773:Anesthesia, Obstetrical / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome