Prenatal surgery of fetal open spinal neural tube defects

A full text article describes some of the unique features of anesthesia for prenatal open and fetoscopic surgery of fetal open spinal neural tube defects.

For uterine relaxation, higher MACs of Sevoflurane were used, as well as nitroglycerin and tocolytics. Higher doses as well as greater hemodynamic disturbance occurred with open surgery. Colloids were used more, presumably to lower the risk of pulmonary edema which occurred in 10%, attributable to gestational physiologic changes, tocolytic administration and liberal fluid therapy.

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