Anesthesia for emergency cesarean section. 2008

M F Haque, and S Sen, and S M Meftahuzzaman, and M M Haque
Mymensingh Medical College, Mymensingh, Bangladesh.

Caesarean Section is one of the most common of all surgical procedures. Common indications for caesarean section may include foetal distress, Cephalopelvic disproportion and failure of labour to progress. Both regional and general anesthesia may be employed for caesarean section. Each is relatively safe and they have their own advantages and disadvantages. Actual decision to adopt one technique over another depends on maternal and foetal status and skill and ability of the anesthesiologist to tackle the situation with the aim of patient and baby safely. Among these, many of the cases come to the hospital as emergency basis. The Anesthesiologists have to face the challenge in providing anesthesia for emergency caesarean section, being the last member in the perinatal team. The challenge faces the risks in involvement of maternal changes in pregnancy, presence of foetal distress and various anesthetic complications arising in perioperative period. Still now anesthetic mishaps are considered as the sixth most frequent cause of maternal mortality. The use of regional Anesthesia reduced the number of deaths at about 80% but deaths involving general anesthesia has not decreased and the incidence is 17 times more than the regional anesthesia. Most of the deaths or complications are related to the airway management (also failed intubation). Better skill and knowledge in physiology, pharmacology and use of modern Anesthetic technique is essential to face the problems.

UI MeSH Term Description Entries
D009774 Obstetrics A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D004632 Emergency Medical Services Services specifically designed, staffed, and equipped for the emergency care of patients. Emergency Care,Emergency Health Services,Emergicenters,Prehospital Emergency Care,Emergency Care, Prehospital,Emergency Services, Medical,Medical Services, Emergency,Services, Emergency Medical,Emergency Health Service,Emergency Medical Service,Emergency Service, Medical,Emergicenter,Health Service, Emergency,Health Services, Emergency,Medical Emergency Service,Medical Emergency Services,Medical Service, Emergency,Service, Emergency Health,Service, Emergency Medical,Service, Medical Emergency,Services, Emergency Health,Services, Medical Emergency
D005260 Female Females
D005316 Fetal Distress A nonreassuring fetal status (NRFS) indicating that the FETUS is compromised (American College of Obstetricians and Gynecologists 1988). It can be identified by sub-optimal values in FETAL HEART RATE; oxygenation of FETAL BLOOD; and other parameters. Nonreassuring Fetal Status,Fetal Status, Nonreassuring
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias

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