Maternal and fetal anaesthesia for fetal surgery

Over the last three decades, advances in early diagnosis of fetal anomalies, imaging and surgical techniques have led to a huge expansion in fetal surgery. A small number of specialist centres perform fetal surgery, which involves high‐risk anaesthesia for the mother and fetus. The anaesthetist plays an integral role within the large multispecialty and multidisciplinary team, involved in planning and delivering care for complex surgical procedures. This article reviews three fetal surgical procedures, congenital diaphragmatic hernia, myelomeningocele repair and ex‐utero intrapartum treatment for airway obstruction. The underlying fetal pathology, surgical management, anaesthetic considerations and risks for both the mother and fetus are described for each. Fundamental to this is the understanding that clear communication and collaboration between all team members is vital to ensure successful outcomes of patients, the mother and the fetus.

• Publication year

  2021

• Venue

  Anaesthesia

• Publication date

  2021-04-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1111/anae.15423PMID 33682103
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• EXIT (ex utero intrapartum treatment) surgery for the management of fetal airway obstruction: A systematic review of the literature.

  2020cited by this paper
• Maternal anesthesia for EXIT procedure: A systematic review of literature

  2019cited by this paper
• Fetal surgery for open spina bifida

  2019cited by this paper
• Fetal Surgery for Myelomeningocele: A Systematic Review and Meta-Analysis of Outcomes in Fetoscopic versus Open Repair

  2017cited by this paper
• Committee Opinion No. 720: Maternal-Fetal Surgery for Myelomeningocele.

  2017cited by this paper
• Procedure-Related Complications and Survival Following Fetoscopic Endotracheal Occlusion (FETO) for Severe Congenital Diaphragmatic Hernia: Systematic Review and Meta-Analysis in the FETO Era

  2016cited by this paper
• Anesthetic Management of 65 Cases of Ex Utero Intrapartum Therapy: A 13-Year Single-Center Experience

  2016cited by this paper
• Long term trends in prevalence of neural tube defects in Europe: population based study

  2015cited by this paper
• Maternal morbidity and reproductive outcomes related to fetal surgery.

  2013cited by this paper
• Ex Utero Intrapartum Therapy.

  2013cited by this paper
• A Randomized Trial of Prenatal versus Postnatal Repair of Myelomeningocele

  2011cited by this paper
• A randomized trial of prenatal versus postnatal repair of myelomeningocele.

  2011cited by this paper
• Ex-utero intrapartum therapy.

  2010cited by this paper
• Fetal surgery and anaesthetic implications

  2008cited by this paper
• Remifentanil for Fetal Immobilization and Maternal Sedation During Fetoscopic Surgery: A Randomized, Double-Blind Comparison with Diazepam

  2005cited by this paper
• The EXIT procedure: experience and outcome in 31 cases.

  2002cited by this paper
• Role of Magnetic Resonance Imaging in Fetal Surgery

  2001cited by this paper
• Management of fetal airway obstruction.

  1999cited by this paper
• Prevention of neural tube defects : Results of the Medical Research Council Vitamin Study MRC VITAMIN STUDY RESEARCH GROUP

  1991cited by this paper
• Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.

  1991cited by this paper

• Fetal Therapy, EXIT Procedure and Neonatal Surgery for Congenital High Airway Obstruction Syndrome: A Successful Sequential Management of a Fetus with Congenital Laryngeal Atresia

  2026cites this paper
• Blood Pressure Optimization During Fetoscopic Repair of Open Spinal Dysraphism: Insights from Advanced Hemodynamic Monitoring

  2025cites this paper
• Anesthesia Management for the Ex-Utero Intrapartum Treatment Procedure: A Case Series and Review of Literature

  2025cites this paper
• The Ex-utero intrapartum treatment procedure: a narrative review

  2025cites this paper
• Direct evidence of fetal responses to noxious stimulations: A systematic review of physiological and behavioral reactions.

  2025cites this paper
• Recent advancements in fetal anesthesia.

  2025cites this paper
• ЧАСТНЫЕ ВОПРОСЫ ФЕТАЛЬНОЙ ХИРУРГИИ

  2025cites this paper
• An Evidence-Based Discussion of Fetal Pain and Stress

  2024cites this paper
• Trends in research related to fetal therapy from 2012 to 2022: a bibliometric analysis

  2024cites this paper
• Immediate postdelivery airway management of neonates with prenatally diagnosed micrognathia: A retrospective observational study

  2023cites this paper
• Recent advances in anaesthesia for intrauterine and foetal surgery

  2023cites this paper
• A Review of EXIT: Interventions for Neonatal Airway Rescue

  2023cites this paper
• Multiple sevoflurane exposures during mid‐trimester induce neurotoxicity in the developing brain initiated by 15LO2‐Mediated ferroptosis

  2023cites this paper
• Debatable issues of anesthesiological provision of fetal surgery

  2023cites this paper
• Maternal and obstetric outcomes after Ex-Utero Intrapartum Treatment (EXIT): a single center experience

  2023influential citation
• Anaesthetic management of fetal congenital diaphragmatic hernia by EXIT: A case report

  2022cites this paper
• Anesthetic Management Of Ex Utero Intrapartum Treatment (EXIT) And Fetal Surgery

  2021cites this paper
• Anesthesiological provision of open fetal surgery

  2021cites this paper
• Ex Utero Intrapartum Technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review.

  2021cites this paper