[Maternal risk from general anaesthesia and regional anaesthesia (author's transl)]. 1980

W Dick

It may be presumed that in 1979, 150 maternal deaths will occur in obstetrics (0.27 per 1000) in the Fed. Rep. of Germany, 40% of which will be due to caesarean sections. From 30% to 50% of this maternal death rate, must be related in one or another aspect to general or local anaesthesia. The maternal morbidity rate may be even higher, because 500,000 parturients a year are treated with caesarean sections, and up to 50% of all parturients with epidural anaesthesia. General anesthesia as well as regional anaesthesia can be maternal risk factors, due to hypoxia or hypercarbia, due to hyper- or hypotension, arrhythmias, inferior vena cava occlusion etc. By endotracheal intubation adequate ventilation can be guaranteed and mothers may be protected from aspiration; the same procedure can also be responsible for hypoxic death or aspiration. Water-electrolyte balance and metabolism carry maternal risks, when inadequate substitution is performed or when fluid and electrolytes are administered in excess, together with modern obstetric drugs. Anaesthesists as well as obstetricians should be aware of the increased maternal risk from general or local anaesthesia. The maternal risk should be minimized. This can either be achieved if experienced anaesthesists only are responsible for obstetric anaesthesia (general as well as epidural, spinal etc.) if anaesthesia (general as well as local) is not considered as a comfortable service only but a strictly indicated medical procedure, and if new methods are developed to overcome the particular maternal risk in some regard.

UI MeSH Term Description Entries
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008428 Maternal Mortality Maternal deaths resulting from complications of pregnancy and childbirth in a given population. Mortality, Maternal,Maternal Mortalities,Mortalities, Maternal
D009017 Morbidity The proportion of patients with a particular disease during a given year per given unit of population. Morbidities
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
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
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
D000772 Anesthesia, Local A blocking of nerve conduction to a specific area by an injection of an anesthetic agent. Anesthesia, Infiltration,Local Anesthesia,Neural Therapy of Huneke,Huneke Neural Therapy,Infiltration Anesthesia
D000860 Hypoxia Sub-optimal OXYGEN levels in the ambient air of living organisms. Anoxia,Oxygen Deficiency,Anoxemia,Deficiency, Oxygen,Hypoxemia,Deficiencies, Oxygen,Oxygen Deficiencies

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