2014, Number 3
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Revista Cubana de Anestesiología y Reanimación 2014; 13 (3)
Anesthetic management in the intrapartum treatment of gastroschisis
Cuesta PD, Garcia VE, González GBN, Trinchet SR, Hidalgo MY
Language: Spanish
References: 13
Page: 287-293
PDF size: 146.99 Kb.
ABSTRACT
Introduction: the procedure ex-utero intrapartum treatment was created in 1997. It
consists in maintaining fetal-placental circulation during the cesarean section to
perform surgical interventions on the newborn. Gastroschisis is a congenital defect
expressed as closure of the abdominal wall. This disorder was present in a newborn
whose 15-year-old mother was surgically intervened, which was a challenge for
anesthesiologists.
Objective: present the anesthesiological evolution of a patient whose fetus was
treated for gastroschisis during the same anesthetic-surgical act as the cesarean
section.
Clinical case: a case is presented of a 15-year-old patient for whom an intervention
for a malformation in her baby was made to coincide with her cesarean section. The
operation was based on placental circulation, for which general orotracheal anesthesia
was administered without using tocolytics. The procedure was performed as planned.
It is considered that success in the intrapartum treatment of gastroschisis is achieved
by following a treatment protocol and working with an interdisciplinary team. In the
procedure, use is made of the placental flow during a cesarean section before the end
of pregnancy. This technique was first performed in Cuba.
Conclusions: establishment of a strategy bearing in mind the specific characteristics
of the case, as well as prior discussion of the procedure, were both crucial to the
result obtained.
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