Anesthetic management of open fetal surgery to correct spina bifida
- Authors: Ostrik K.A.1, Pyregov A.V.1, Gladkova K.A.1, Kostyukov K.V.1, Shmakov R.G.1
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Affiliations:
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
- Issue: No 9 (2020)
- Pages: 255-261
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/329659
- DOI: https://doi.org/10.18565/aig.2020.9.255-261
- ID: 329659
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Abstract
Background. Today, open fetal surgery is a rare intervention, the main goal of which is to correct intrauterine fetal malformations. Studies have provided evidence that intrauterine correction of spina bifida reduces the incidence and severity of neurological disorders, compared with the standard surgical treatment for newborns. Anesthetic management of open fetal surgery is complex and differs from the standard anesthesia management during pregnancy. Case report. The paper describes two clinical cases of anesthesia of an open fetal surgical intervention for congenital malformation - myelomeningocele (spina bifida). The surgery was performed in the second trimester of pregnancy. Pregnant women underwent combined anesthesia with high doses of an inhalation anesthetic. This clinical case demonstrates the features of anesthesia and the approach to choosing the tactics for anesthetic management of open fetal surgery. It shows that such operations cannot be performed without well-coordinated work of a large multidisciplinary team of professionals. Conclusion. Fetal surgery is a rapidly growing field of medicine. Anesthetic management of fetal surgery is developing together with progress in surgical techniques. Anesthetic management is based on knowledge of the physiology and pathophysiology of the mother and fetus. Open fetal surgery cannot be performed without the multidisciplinary teamwork of professionals, who include obstetricians/gynecologists, neurosurgeons, anesthesiologists/resuscitators, neonatologists, fetal medicine specialists, operating nurses, anesthetic nurses, and midwives; operating rooms prepared with appropriate equipment are also needed.
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About the authors
Kirill A. Ostrik
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: Kirillplatonovich@yandex.ru
anesthesiologist-resuscitator
Aleksey V. Pyregov
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: a_pyregov@oparina4.ru
Dr. Med. Sci., Professor, Director of the Institute of Anesthesiology, Reanimatology and Transfusiology
Kristina A. Gladkova
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: k_gladkova@oparina4.ru
Ph.D., Senior Researcher at the Department of Fetal Medicine, Institute of Obstetrics, Head of the 1st Obstetric Department of Pathology of Pregnancy
Kirill V. Kostyukov
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: kostyukov_k@yahoo.com
M.D., Ph.D., Senior Researcher at the Department of Fetal Medicine, Institute of Obstetrics, Physician at the Unit of Functional and Ultrasound Diagnostics, Department of Diagnostic Imaging
Roman G. Shmakov
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: mdshmakov@mail.ru
MD, RAS Professor, chief medical officer
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