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Continuing Education in Anaesthesia, Critical Care & Pain 2006 6(2):83-85; doi:10.1093/bjaceaccp/mkl008
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 6 Number 2 2006 © The Board of Management and Trustees of the British Journal of Anaesthesia [2006]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Anaesthesia for non-obstetric surgery during pregnancy

Nina Kylie Dorothy Walton, MBChB FRCA
Consultant Anaesthetist, Mid Essex Hospital Trust Chelmsford, Essex, UK Fax: 01245 516243 E-mail: waltonnina@hotmail.com (for correspondence)

Venkata Krishnaker Melachuri, FRCA MD (Anaesthesiology)
Specialist Registrar in Anaesthesia, Queen Charlotte's Hospital Du Cane Road, London W12 0HS, UK
The first 150 words of the full text of this article appear below.


Key points

Regional anaesthesia should be used in preference to general anaesthesia where appropriate.

Optimize and maintain normal maternal physiology.

A multidisciplinary approach with senior involvement needs to be established early in the management.

If possible, surgery should be delayed until the second trimester. Elective surgery should not be performed.

Avoid all unwanted drug effects on the fetus.

 

It is estimated that some 1–2% of pregnant women in developed countries undergo anaesthesia during their pregnancy for surgery unrelated to the delivery.1 Appendicitis, ovarian torsion and trauma are among the more common indications for surgical intervention. Less commonly, cardiac and neurological procedures are undertaken during pregnancy. In order to provide safe anaesthesia for mother and fetus, it is essential to remember the physiological and pharmacological changes that characterize the three trimesters of pregnancy; these changes can pose hazards for both of them. The anaesthetist has the following goals:

  1. optimize and maintain . . . [Full Text of this Article]


   Pre-anaesthetic assessment
 

   Drug considerations
 

   Anaesthesia and gestation
 

   Non-viable fetus
 

   Anaesthesia for conception and in the first trimester
 

   Anaesthesia in the second trimester
 

   Anaesthesia for the third trimester
 

   Fetal monitoring
 

   Anaesthetic technique
 

   Laparoscopic surgery
 

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