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Sedating Pregnant Patients for Minimally Invasive Fetal Interventions

  • Obstetric Anesthesia (LR Leffert, Section Editor)
  • Published:
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Abstract

Purpose of Review

This article discusses sedation in pregnant patients undergoing minimally invasive fetal interventions. It includes a review of the goals of sedation in this population, relevant existing guidelines, physiological considerations unique to pregnant patients undergoing sedation, and a brief discussion of perioperative management using pharmacologic and nonpharmacologic anxiolysis.

Recent Findings

Sedation is used by most fetal therapy centers performing minimally invasive fetal interventions in combination with local or neuraxial anesthesia. Existing guidelines recommend no more than a moderate plane of sedation for pregnant patients. The impact of individual medications on the pregnant patient, fetus, and operating conditions including uterine contractility are areas of investigation relevant to fetal interventions.

Summary

While most fetal centers use sedation for pregnant patients undergoing minimally invasive fetal surgery, no single regimen has been identified as optimal. Vigilance in maintaining a minimal-moderate level of sedation is essential for mitigating risks when sedating pregnant patients.

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  1. Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children’s Hospital Fetal Center, Baylor College of Medicine, 6621 Fannin St, Ste A3300, Houston, TX, 77030, USA

    Claire Naus & Caitlin Sutton

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Correspondence to Caitlin Sutton.

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Naus, C., Sutton, C. Sedating Pregnant Patients for Minimally Invasive Fetal Interventions. Curr Anesthesiol Rep 13, 59–66 (2023). https://doi.org/10.1007/s40140-023-00551-7

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