In utero intervention for fetal anomalies or abnormal placentation should only occur for conditions known to result in ongoing irreversible harm to the fetus or increased risk to the mother. For in utero fetal treatment procedures there should be evidence that potential harm from the fetal lesion is best mitigated by intervention at a gestational age with superior outcomes than ex utero neonatal treatment. Although most fetal anomalies are not amenable to in utero treatment, two conditions with significant evidence of improved outcomes include use of fetoscopic laser photocoagulation to treat twin-to-twin transfusion syndrome and mid-gestational in utero open fetal surgery to treat myelomeningocele. Minimally invasive fetal treatment techniques are typically performed under local or regional anesthesia, while open fetal procedures are done under general anesthesia. Successful fetal intervention requires extensive multidisciplinary planning and collaboration. In addition to anesthetic considerations employed for nonobstetric surgery during pregnancy, fetal anesthesia and analgesia, fetal monitoring, uterine relaxation, and preparation for emergent maternal and fetal events are all necessary. Future research into anesthetic techniques for various maternal-fetal procedures is key to optimizing clinical outcomes and advancing the field of fetal surgery and maternal-fetal medicine.

The physical and psychological changes a woman undergoes during pregnancy impact various areas of her life, including her sexual life. Sexuality during pregnancy is important, as there is a strong link between sexual satisfaction and overall life satisfaction. Women’s sexual response, classically divided into four stages (excitement/arousal, plateau, orgasm, and resolution), is more complex. Several hormones are involved in sexual arousal, such as oxytocin, β-endorphin, and prolactin. The effect of orgasm during pregnancy has not been well studied and available evidence is lacking. In the absence of evidence of harm, it seems reasonable to conclude that orgasm is safe in pregnancy, at least in low-risk ones.