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Before surgery, you will meet with someone from our fetal care team who will ask you about your medical history, allergies, medications, previous anesthetic experiences and health status. After your care team reviews your medical history and laboratory tests, they will discuss with you the risks and benefits of the anesthesia. Usually, the minimally invasive fetal surgery (with small incisions) uses epidural anesthesia, while open fetal surgeries require general anesthesia.
Fetal surgeries are performed in our fetal surgery unit, located at Cincinnati Children’s. On the day of surgery, you will check in at the Admissions Center on the first floor of Cincinnati Children’s before taking the elevator to the Fetal Care Center. Before going to the operating room, you will change into a hospital gown and the nurses will insert an intravenous (IV) catheter. You may receive some medicine through the IV to help you relax just before you are taken to the operating room.
After arriving in the operating room, your anesthesiologist will place your epidural, if you are going to receive one. Once the epidural takes effect, you will lie down and surgeons will use monitoring equipment to check on your heart’s electrical activity, your blood pressure and the oxygen levels in your blood.
If you are having fetoscopy, you may receive additional medicine to help you relax, and you may even take a nap during the surgery.
If you are having open fetal surgery or an EXIT procedure, your anesthesiologist will give you a general anesthetic to put you to sleep.
Once you are asleep, our surgeons will place a breathing tube in your windpipe to ensure you receive enough oxygen during the procedure. They will place a catheter in your bladder to measure your urine and will insert a special blood pressure monitor (an arterial line) in an artery (usually in the wrist). This equipment allows us to monitor your oxygen and carbon dioxide levels, fluid or hydration status and blood pressure throughout the procedure, keeping you and your baby as safe as possible during surgery.
After surgery, you will wake up in the operating room. Your surgeons will remove your breathing tube before you are fully awake, and may remove the arterial catheter and epidural catheter as well.
As you wake up more fully, the Fetal Care Center team will move you to a post-operative recovery area where our specialized obstetric nurses will stay with you until you are completely awake. Then they will transfer you to a special recovery room in the Fetal Care Center for ongoing care and recovery.
If you have an EXIT procedure, your baby will most likely be moved directly to the Newborn Intensive Care Unit at Cincinnati Children’s. Our specialists will use a breathing tube after delivery to assist your baby’s breathing, and will give your baby medicine through an intravenous catheter as needed. This care will be coordinated by a team of neonatologists, pediatric surgeons and nurses who specialize in the care of newborns in an intensive care unit.
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