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Anesthesia for fetal interventions: Caring for mother and fetus prior to birth

Olivia Nelson1,2, Elaina E Lin1,2

  • 1Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

Journal of Anesthesia and Translational Medicine
|April 3, 2026
PubMed

Fetal surgery is an expanding domain in which the developing fetus receives therapeutic interventions aimed at reducing mortality and/or morbidity. It presents unique challenges to the anesthesiologist, as it involves managing two simultaneous patients and necessitates the integration of both obstetric and pediatric anesthesia. Fetal therapies range from minimally invasive techniques to open mid-gestation procedures to near-term procedures performed with the fetus partially delivered while on placental circulation. In this overview, we delineate the indications for fetal surgery, review the principles for administering anesthesia in these cases, and outline the anesthetic strategies for minimally invasive, open mid-gestation, and ex utero intrapartum treatment (EXIT) procedures.

Keywords:
EXIT procedureFetal airwayFetal anesthesiaFetal myelomeningoceleFetal surgeryObstetric anesthesia

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