general anaesthesia in obstetrics

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The following ought to be considered in anaesthetising a woman in labour:

  • normotension, because of aorto-caval compression, may not actually be normal, and may be harmful to the fetus
  • the size of the lungs are reduced in a term mother, and the oxygen requirements are higher
  • acid aspiration is a common complication with the high pressures of labour, especially when combined with agent which delay gastric emptying (eg opiates)
  • direct effects of drugs on the fetus can be avoided with a quick delivery, ie no time for transplacental diffusion
  • anaesthesia is always a risk in labour; an emergency anaesthetic constitutes a high risk.
  • most of the mortality and morbidity results from failure to intubate with subsequent hypoxia and aspiration.
  • the anaesthetic must remove awareness!

Last reviewed 01/2018

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