الفهرس 
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Abstract
This study is dealing with anaesthesia for cases of foetal surgery.
Foetal intervention was first described by Liley in (1963) for treatment of infants with erythroblastosis foetalis. However, until recently, few therapeutic options existed when serious foetal anomalies were present. If pregnancy was not medically terminated, many of these infants would die in-utero or shortly after birth. In the subsequent 25 years, the potential foetal surgery improved dramatically.
Today, surgical intervention early in foetal development for conditions such as diaphragmatic hernia, hydronephrosis and obstructive hydrocephalus is a viable obtion because of improvements of in-utero diagnostic capabilities and new surgical techniques. As in any surgical procedure, the quality of anaesthesia is critical to the outcome of the operation.
In case of intrauterine foetal surgical procedures, the anaesthesiologist is dealing with two patients, the mother and the foetus. So, it is important to study the foetal development to deal with the foetus.
Foetal development can be classified into 3 stages, the first one extends for 2 weeks. The second stage extends from the end of the 2”d week to the end ofthe gth week. The third stage extends from the end of the gth week to the end of pregnancy. Development during the third stage consists of growth and maturation of structures that were formed during the second stage.
It is important to study physiology of the foetus and realise that, every system in the body shows differences in the
foetus that are not present in the adult human being.
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Monitoring of the foetal condition during foetal life is important. Foetal status can be evaluated by observing or testing a number of foetal parameters, some passively by the non-stress test, or biophysical profile and foetal movement count, others actively by the contraction stress test.
Other methods of assessment of foetal condition are vibroacoustic stimulation, foetal echocardiography and percutaneous foetal umbilical blood sampling.
When we study the anaesthesia for cases of foetal surgery, it is important to study the function of placenta and transfere of drugs across it because this affects directly the foetus.
Placental exchange occurs by one of five mechanisms simple diffusion, facilitated diffusion, active transport, pinocytosis, breaks and bulk flow.