Fetal surgery has evolved in the last decades, mostly because of the
technical advances in therapeutic and monitoring devices. The timing and mode of
surgery depend on the disease to be treated. Local, neuraxial or general anesthesia can
be used on the mother. In some cases, fetal analgesia and paralysis are needed.
The idea of treating the fetus as a patient has evolved in recent years, as a consequence
of improvements in diagnostic imaging and surgical devices. In fetuses with congenital
airway obstruction, intrapartum surgical correction or airway management can be
performed while maintaining perfusion via the umbilical cord.
In 1980, maternal laparotomy and hysterotomy were proposed to treat fetuses with
congenital and developmental abnormalities, and the prerequisites for maternal-fetal
surgery were first formulated in 1982. They are still in use with some minor
modifications. A multidisciplinary approach to fetal intervention is essential. Both
obstetric and pediatric anesthesia is involved and it a close collaboration with surgical
teams is necessary.
Keywords: Exit Procedure, Fetal Anesthesia, Fetal Surgery, Fetal Surgery Anesthesia, Maternal Anesthesia, Presto Procedure.
