Before Fetal Surgery
Before surgery, you will meet your anesthesiologist. You will be asked questions about your medical history, allergies, current medications, previous anesthetic experiences and current health status. The anesthesiologist will examine your airway, heart, lungs and back. He or she will ask questions about your baby's gestational age, any tests and procedures done during pregnancy, and any known abnormalities that the baby may have.
After your anesthesiologist reviews your entire medical history as well as laboratory tests, he or she will discuss with you the risks and benefits of the type of anesthesia that is recommended for your surgery. Usually, the minimally invasive surgery (with the small incisions) has epidural anesthesia, and the fetal surgeries that require a larger incision for the mother (either in the middle of pregnancy or at the end) have general anesthesia.
The Day of Your Fetal Surgery
On the day of surgery, you will come to the Cincinnati Fetal Center at Cincinnati Children's for check-in. Before going to the operating room, you will change into a hospital gown and have an intravenous (IV) catheter placed. You will then be taken to the preop holding area where you will meet your anesthesia team. You may receive some medicine through the IV to help you relax just before leaving for the operating room.
After arriving in the operating room, you will sit up on the bed to have your epidural placed (if one is going to be used for your surgery). Once the epidural is in place, you will lie down and routine equipment will 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 (either in the middle of pregnancy or at delivery), you will then be given medicine to induce general anesthesia.
Once you are asleep, a breathing tube will be placed in your windpipe, a catheter will be placed in your bladder to measure your urine, and a special blood pressure monitor (an arterial line) may be placed 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, at all times in order to keep you and your baby as safe as possible during surgery.