Key result
Combined spinal epidural anesthesia with dexmedetomidine provided stable maternal hemodynamics during fetal pulmonary valvuloplasty, resulting in a successful full-term delivery.
Why the study?
Anesthesia management for fetal pulmonary valvuloplasty is difficult, and few reports have been published regarding specific implementation and intraoperative management for both mother and fetus.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Combined spinal epidural anesthesia with dexmedetomidine, alongside umbilical vein fetal anesthesia, may be a suitable and safe anesthetic approach for fetal pulmonary valvuloplasty.
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.
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Lei et al. (2023) conducted a case report in Fetal pulmonary valvuloplasty (n=1). Combined spinal epidural anesthesia (CSEA) with dexmedetomidine was evaluated. Combined spinal epidural anesthesia with dexmedetomidine provided stable maternal hemodynamics during fetal pulmonary valvuloplasty, resulting in a successful full-term delivery.
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