The blind spot in obstetric anesthesia: Intra-surgical fetal monitoring

Abstract

Introduction: There is a big gap in fetal monitoring in obstetric patients undergoing cesarean section during the transoperative period. Despite the astonishing technological developments in all medical areas, we have failed to develop a practical method for the evaluation of the fetus wellbeing during a c-section intervention. Objective. A non-invasive and practical method is suggested that can be used in a site distant from the abdominal surgical field to record the continuous fetal heart rate as an indicator of fetal wellbeing. This task would not only involve the anesthesiologist, but the obstetrician and the pediatrician as well. Methodology. Producing an article that should be food for thought, based on a question asked by students of anesthesiology in the OR (graduate and postgraduate students), about a practical method for intraoperative fetal, noninvasive monitoring. The search was conducted using the Medline, Ovid and Science Direct data basis. Results. Notwithstanding the absence of an appropriate fetal monitoring method (optimal and practical) for this period of time in the OR, it is mandatory to find a technology-based solution to assess the wellbeing of the fetus during the transoperative period of the c-section, firstly because there are multiple factors that may extend the surgical time and become a determining factor for the lack of control of a hypoxic or schemic event of the fetus; secondly, because safety of obstetric and fetal anesthesia must be demanding and is critical.