Anaesthetic management of obstetric emergencies

Indian Journal of Anaesthesia
Pradeep A Dongare, Madagondapalli S Nataraj

Abstract

Obstetric emergencies are a challenge both for the obstetrician and the anaesthesiologist. The incidence of caesarean sections as per the National Family Health Survey published in 2015-16 was 17.2%. In 7.6% of cases, the decision to conduct a caesarean section was taken after the onset of labour pains. Caesarean sections are classified depending on the urgency into four categories. The target decision to delivery interval for category 1 caesarean section is less than 30 min. This is used as an audit tool for the efficiency of an obstetric service. The management of these emergencies involves a rapid assessment, with minimal investigations. Although general anaesthesia is considered to have higher morbidity and mortality, category 1 caesarean sections may still warrant this technique. Rapid sequence spinal anaesthesia is replacing general anaesthesia for many of the category 1 indications. In category 2 and 3 caesarean sections, spinal anaesthesia still remains the technique of choice. Failed intubation, failed neuraxial block, extensive neuraxial block, awareness under anaesthesia, thromboembolism, amniotic fluid embolism, haemorrhage and maternal collapse are some of the complications. Haemorrhage is said to be the leading ca...Continue Reading

References

May 4, 2004·The British Journal of Oral & Maxillofacial Surgery·Zuhal Küçükyavuz, Mine Cambazoğlu
Sep 28, 2004·Journal of Biosocial Science·Karen HardeeTerence H Hull
Jun 30, 2011·European Journal of Anaesthesiology·Ian SmithUNKNOWN European Society of Anaesthesiology

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