Fetal monitoring in neurosurgery: An essential paradigm?

Neurosurgical procedures during pregnancy are not uncommon, and anesthetic management of these patients are complicated by the physiologic changes of pregnancy, effects of anesthetic agents on fetus, and a need for vigilance to prevent a possibility of fetal demise. The value of intraoperative fetal heart rate (FHR) monitoring though controversial, is immense, and with various modalities available to choose from, necessary interventions could be made before fetal viability is jeopardized. We report the utility of intraoperative FHR monitoring using ultrasonography in case of a 32-year-old, 28 weeks, pregnant female, G4P(1)A2, posted for bifrontal craniotomy and excision of meningioma with subfalcine herniation.