Obesity is a modern epidemic affecting all aspects of healthcare. Childbirth and anaesthesia are rendered more hazardous for the obese parturient. The fetus is at increased risk of congenital abnormality, complications of pregnancy, and harm during childbirth. The obstetric anaesthetist, obstetrician, and midwife share the increased stress of managing these risks. There are thus no winners created...
The obstetric anaesthetist may be required to anaesthetize women for a variety of procedures ranging from the relatively minor elective operation to the dire life threatening emergency. We discuss the procedures that will be commonly encountered and the anaesthetic options currently available.
Controversial areas surrounding the management of massive obstetric haemorrhage are discussed including the use of general versus regional anaesthesia, cell salvage techniques, antifibrinolytic agents, recombinant factor VIIa and radiological interventions.
Haemodynamic stability is sometimes difficult to achieve during regional anaesthesia for caesarean section because of the high blockade required to ensure maternal comfort. This can lead to unpleasant symptoms at best, or life threatening circulatory collapse at worst. There are several anaesthetic techniques and antihypotensive regimens from which to choose, and appropriate choice with careful application...
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