Advanced hemodynamic monitoring during fetal surgery

Abstract

Fetal surgery is performed in several different fetal diagnosis centers with increasing frequency. Continuous tocolytic medication and effects of inhaled anesthetics on parasympathetic reflex vasodilation constitute a challenge for uteroplacental blood perfusion. The stability of pulmonary gas exchange and maternal hemodynamics is important. Otherwise maternal pulmonary oedema may easily occur according to an increase in pulmonary vascular permeability and extravascular lung water. Fluid management is required to ensure the continuity of the uteroplacental circulation and has to be performed very carefully. Hemodynamic monitoring parameters show us the principles of fluid management and allow us to draw a road map. In this review we aimed to present a summary concerning advanced hemodynamic monitoring during fetal surgery. (C) 2016 Elsevier Ltd. All rights reserved.