We report the first successful case of fetal surgery for spina bifida repair in Peru. A pregnant woman was referred to our center at 23 weeks of gestation because of prenatal diagnosis of spina bifida. A multidisciplinary team was formed with the goal of performing the first open intrauterine surgery in Peru. A successful intrauterine surgery was carried out at 25 weeks of gestation and a healthy infant was born by cesarean section at 37 weeks of gestation. We demonstrated the feasibility of this complex intrauterine surgery in our local setting.

We report the first successful case of fetal surgery for spina bifida repair in Peru. A pregnant woman was referred to our center at 23 weeks of gestation because of prenatal diagnosis of spina bifida. A multidisciplinary team was formed with the goal of performing the first open intrauterine surgery in Peru. A successful intrauterine surgery was carried out at 25 weeks of gestation and a healthy infant was born by cesarean section at 37 weeks of gestation. We demonstrated the feasibility of this complex intrauterine surgery in our local setting.

Objective: Neuroaxial analgesia is the most effective technique to treat labor pain, however, there are still concerns regarding the undesirable effects. Objective: To evaluate the association between epidural analgesia maintained by programmed intermittent epidural boluses (PEIB) and maternal perinatal complications.  Materials and methods: Observational, analytical study of Cohort type in pregnant women between 18 and 35 years, in labor with cervical dilation of 4 centimeters or more, grouped in two cohorts according to administration or not of epidural analgesia: In pregnant women of Group A, administered bolus epidural analgesia, with maintenance by BEIP with bupivacaine 0.0625% and fentanyl 25 ug in 10cc every 60 minutes; in pregnant women of group B, epidural analgesia was not administered. Results: The duration of the dilation and expulsion period was longer in the group...

Objective: Neuroaxial analgesia is the most effective technique to treat labor pain, however, there are still concerns regarding the undesirable effects. Objective: To evaluate the association between epidural analgesia maintained by programmed intermittent epidural boluses (PEIB) and maternal perinatal complications.  Materials and methods: Observational, analytical study of Cohort type in pregnant women between 18 and 35 years, in labor with cervical dilation of 4 centimeters or more, grouped in two cohorts according to administration or not of epidural analgesia: In pregnant women of Group A, administered bolus epidural analgesia, with maintenance by BEIP with bupivacaine 0.0625% and fentanyl 25 ug in 10cc every 60 minutes; in pregnant women of group B, epidural analgesia was not administered. Results: The duration of the dilation and expulsion period was longer in the group...

To the Editor, Spinal anesthesia is considered the technique of choice in most cesareans, with hypotension being the most common adverse effect. The symptoms that frequently accompany hypotension are: nausea, vomiting, dyspnea and neonatal deleterious effects, among them, low Apgar score and acidosis in cord blood gas analysis1. The question is what is the most effective strategy to prevent and treat hypotension secondary to spinal anesthesia for caesarean section? It is crucial in obstetric anesthesia and the response is related to the physiological events that lead to hypotension. For many years the administration of a volume of crystalloids prior to the placement of spinal anesthesia was mandatory, just as ephedrine was considered the vasopressor of choice to treat such hypotension. The available scientific evidence shows us the opposite2.

Introduction. In twin pregnancies with a diagnosis of Reversed Arterial Perfusion (TRAP), sequence, is highly recommendedto be managed by fetoscopic fetal surgery through bipolar photocoagulation, in order to improve the prognosis of one ofthe fetuses (pump fetus), in contrast of the other one which is acardiac and / or anencephalic. In this regards anesthesiamanagement has to ensure maternal and fetal safety and provide excellent surgical conditions. Objective. To describe theanesthetic management of a patient diagnosed with TRAP sequence scheduled for bipolar fetoscopic-photocoagulation.

Introduction. In twin pregnancies with a diagnosis of Reversed Arterial Perfusion (TRAP), sequence, is highly recommendedto be managed by fetoscopic fetal surgery through bipolar photocoagulation, in order to improve the prognosis of oneof the fetuses (pump fetus), in contrast of the other one which is acardiac and/or anencephalic. In this regards anesthesiamanagement has to ensure maternal and fetal safety and provide excellent surgical conditions. Objective. To describe theanesthetic management of a patient diagnosed with TRAP sequence scheduled for bipolar fetoscopic-photocoagulation.

Introduction. In twin pregnancies with a diagnosis of Reversed Arterial Perfusion (TRAP), sequence, is highly recommendedto be managed by fetoscopic fetal surgery through bipolar photocoagulation, in order to improve the prognosis of one ofthe fetuses (pump fetus), in contrast of the other one which is acardiac and / or anencephalic. In this regards anesthesiamanagement has to ensure maternal and fetal safety and provide excellent surgical conditions. Objective. To describe theanesthetic management of a patient diagnosed with TRAP sequence scheduled for bipolar fetoscopic-photocoagulation.

Introduction. In twin pregnancies with a diagnosis of Reversed Arterial Perfusion (TRAP), sequence, is highly recommendedto be managed by fetoscopic fetal surgery through bipolar photocoagulation, in order to improve the prognosis of oneof the fetuses (pump fetus), in contrast of the other one which is acardiac and/or anencephalic. In this regards anesthesiamanagement has to ensure maternal and fetal safety and provide excellent surgical conditions. Objective. To describe theanesthetic management of a patient diagnosed with TRAP sequence scheduled for bipolar fetoscopic-photocoagulation.

We report a series of three cases with prenatal diagnosis of congenital cystic adenomatoid malformation of the lung, macrocystic type, treated in utero with thoraco-amniotic shunting. This highly specialized intervention is feasible in our local setting. The three cases survived. A mini-review of this condition is presented and an algorithm of prenatal management is proposed.

We report the first successful case of fetal surgery for spina bifida repair in Peru. A pregnant woman was referred to our center at 23 weeks’ gestation because of prenatal diagnosis of spina bifida. We formed a multidisciplinary international team with the goal of performing the first open intrauterine surgery in Peru. We performed a successful intrauterine surgery at 25 weeks of gestation and a healthy infant was born by cesarean section at 37 weeks of gestation. We demonstrated the feasibility of this complex intrauterine surgery in our local setting.