Anesthetic management of fetal pulmonary valvuloplasty: A case report

• Published in: Open medicine (Warsaw, Poland) Vol. 18; no. 1; pp. 230 - 7
• Main Authors: Lei, Xiaofeng, Huang, Xuezhu
• Format: Journal Article
• Language: English
• Published: Warsaw De Gruyter 02-11-2023; Walter de Gruyter GmbH
• Subjects: anesthesia for fetal surgery; Case reports; combined spinal epidural anesthesia; fetal surgery; intrauterine surgery; pulmonary valve stenosis
• ISSN: 2391-5463; 2391-5463
• DOI: 10.1515/med-2023-0835

Anesthesia management of fetal pulmonary valvuloplasty (FPV) is difficult, requiring careful consideration of both the mother and the fetus. Few reports have been published on specific anesthesia implementation and intraoperative management. We report the case of a pregnant woman who was treated with FPV under combined spinal epidural anesthesia (CSEA) with dexmedetomidine in the second trimester of pregnancy. Meanwhile, the application of fetal anesthesia through the umbilical vein was optimal. During the operation, the vital signs of the pregnant woman were stable with no complications and the fetal bradycardia was corrected by intracardiac injection of epinephrine. Four months postoperatively, a boy was born alive by full-term transvaginal delivery. CSEA may be a suitable anesthesia method for FPV surgery. Nevertheless, maternal hemodynamic stability maintenance, effective fetal anesthesia, and timely fetal resuscitation were necessary.