Introduction

Maternal mortality remains very high in many resource poor countries. A well managed obstetric anesthetic service can help to reduce maternal mortality. Obstetric anesthesia is a demanding but gratifying subspecialty of anesthesia. The widespread acceptance and use of regional anesthesia for labor has made obstetric anesthesia a major part of most anesthetic practices. The nature of obstetric anaesthesia is so critical that it demands anesthesia service be readily available continuously and that cesarean section be started within 30 min of the recognition for its need. Moreover, high-risk patients, such as those undergoing a trial of vaginal birth after a previous cesarean delivery, may require the immediate availability of anesthesia services.

Although most parturients are young and healthy, they nonetheless represent a high-risk group of patients for all the reasons discussed in the preceding chapter.

In this module you will learn about physiologic changes that occur during pregnancy. You will also learn about techniques anesthesia for cesarean section and obstetric procedures, anesthesia during pregnancy for non obstetric procedures and anesthesia for preeclampsia and hemorrhage. The module ends with a review of neonatal resuscitation and anesthetic considerations for pediatrics.

Major physiological changes occur during pregnancy. These changes are brought about by hormonal and mechanical factors from the enlarged uterus. In this study session you will learn about major physiological changes that occur during pregnancy. An understanding of these physiological changes is vital: as they have implications for safe care of pregnant patient and conduct of anaesthesia. The knowledge of physiological changes also allows you to anticipate the effect that pregnancy will have on co-morbid medical conditions . Overall, at the end of this session you will be able to Identify common physiologic changes during pregnancy and their anesthetic implication.