Which Anesthesia Would You Prefer for an EXIT Surgery of This Patient?

Case presentation A 37-year-old woman at 38 weeks of gestation, presented to the gynecologist with the diagnosis of fetal cervical lymphangioma with partial obstruction of the trachea. A potential risk of post-delivery airway compromise was also reported. The findings were confirmed by an MRI scan at 31st weeks of gestation. It revealed a right cervical cystic formation (60x38x52 mm) with a tongue protrusion (Image A).

A decision of immediate cesarean delivery followed by ex utero intrapartum treatment (EXIT) was made. The EXIT procedure is corrective surgery for a fetus with congenital malformations that possess the risk of airway compromise and perinatal death. The procedure allows maintaining the uteroplacental circulation during the removal of tracheal clips immediately after the C-section delivery. During intraoperative care, which type of anesthesia would you recommend for this…