Presented by: Tareq Salwati SSC-Anaes Department of Anesthesiology Maternity and Childrenss Hospital Jarwal, The Holy Capital
Labor unsafe for mother and fetus: Increased risk of uterine rupture Previous classic cesarean section Previous extensive myomectomy or uterine reconstruction
Labor unsafe for mother and fetus: Increased risk of maternal hemorrhage Central or partial placenta previa Abruptio placentae Previous vaginal reconstruction
Dystocia
Abnormal fetopelvic relations Fetopelvic disproportion Abnormal fetal presentation Transverse or oblique lie Breech presentation Dysfunctional uterine activity
General anesthesia
General anesthesia
General anesthesia
Advantages:
Rapid onset
General anesthesia Advantages: Anesthetist's hands are free for fluid management and hemodynamics control in cases of major bleeding.(that is, the airway is already secured)
General Anesthesia
Disadvantages:
Regional anesthesia
Regional anesthesia
Advantages:
Regional anesthesia Advantages: Anesthesia related mortality much lower than general anesthesia.
?
Why is regional anesthesia preferred when ever possible?
Because of:
Anesthetic Mortality
Anesthetic Mortality
Anesthesia accounts for approximately 23% of maternal deaths.
That is, General Anesthesia cases death 16 X more frequent than regional Anesthesia !!!!!
THANK YOU!
Reference: Clinical Anesthesiology, G.Edward Morgan,Jr. et al , 4th edition, 2006 PocketMedicine Obstetric Anesthesia Version 1.1.0/2005.11.7 LWW mobile Clinical Anesthesia, 5th edition Version 8.0.26/2007.4.5 Liability assiciated with obstetric anesthesia, Anesthesiology 2009: 110:131-9
www.salwati.com