Anesthetic management of a neonate receiving prenatal repair of gastroschisis

摘要

Gastroschisis requires surgical repair, which is generally performed after birth. We report a case in which a fetus with gastroschisis underwent the abdominal wall defect repair before birth. To ensure reliable operating conditions for the repair (to prevent fetal movement and crying), the fetus received deep anesthesia via placental transfer of maternally administered anesthetics. Meanwhile, the ex utero intrapartum treatment procedure was performed to ensure fetal oxygen supply, which was likely to be compromised by the deep fetal anesthesia. The procedure last for 23 minutes and the gastroschisis was successfully repaired before the neonate was delivered. Maternal hemodynamics was kept stable during this surgical procedure. The prenatal repair of abdominal wall defect is safe for the mother and the fetus, which could potentially improve the neonatal outcomes.