Around 0.75-2% of pregnant women undergo non-obstetric surgeries, most commonly for appendicitis or cholecystitis. Anesthesiologists must provide safe anesthesia for both the mother and fetus by considering the physiological changes of pregnancy and modifying anesthetic techniques and drugs to avoid fetal asphyxia, teratogenic drugs, preterm labor, hypotension, hypovolemia, hypoxia, and hypothermia in the mother. Proper counseling of the patient and family as well as understanding maternal and fetal physiology are important for safe anesthesia during pregnancy.
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2. 0.75-2% pregnant women undergo surgeries
Most common indication acute abdominal
infection
Appendicitis(1:2000)
Cholecystitis(8:10000)
3. Directly related to pregnancy - e.g. Cervical
encirclage
Indirectly related to pregnancy - e.g.
Ovarian Cystectomy
Not related to pregnancy -
e.g.Appendicectomy(m.c)
4. Anaesthesiologist who care for pregnant patient
undergoing non-obstetric surgery must provide
safe anaesthesia for both mother & foetus.
To maintain maternal safety the physiological
&anatomical changes of pregnancy must be
considered,anaesthetic technique & drug
administration modified accordingly.
Foetal wellbeing is related to avoidance of
foetal asphyxia& teratogenic drugs & preterm
labour.
5. Optimization & maintenance of normal maternal
physiological function.
Optimization & maintenance of uteroplacental
blood flow & 02delivery.
Avoidance of unwanted drug effects on the
foetus.
Avoidance of stimulating myometrium.
Avoidance of awareness during GA.
Using regional anaesthesia, if possible.
To prevent hypotension, hypovolemia, hypoxia
and hypothermia
11. Teratogenicity is defined as the ability of a drug to cause fetal
abnormalities or deformities.
During the period of organogenesis the embryo is most
vulnerable to teratogenic effects .
16. UTEROPLACENTAL PERFUSION &FETAL
OXYGENATION
Most serious risk during non obstetric surgery
is intrauterine asphyxia.
Fetal oxygenation depends on maternal
oxygen delivery and uteroplacental perfusion