Anesthetic management of fetal pulmonary valvuloplasty: A case report

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.

Automated summary

The anesthesia management of fetal pulmonary valvuloplasty (FPV) is complex and requires consideration of both the mother and the fetus. This case report highlights the successful use of combined spinal epidural anesthesia (CSEA) with dexmedetomidine for FPV in a pregnant woman. The maternal vital signs remained stable, and the fetal anesthesia was effective, with fetal bradycardia corrected by epinephrine. A healthy baby was delivered four months postoperatively.