Summary

Summary of study session II

In study session II you have learnt

• The majorities of women of childbearing age are healthy and would be considered to be at very good operative surgical risk, pregnancy, however, certain maternal/fetal factors, and preexisting medical conditions significantly increase surgical and obstetric risks.
• Pulmonary embolism and preeclampsia/pregnancy-induced hypertension, amniotic fluid embolism and intracranial hemorrhage emerge as important additional causes of death.
• By far the most common morbidities encountered in obstetrics are severe hemorrhage and severe preeclampsia.
• Anesthesia accounts for approximately 2–3% of maternal deaths and most deaths occur during or after cesarean section.
• The risk of an adverse outcome appears to be much greater with emergency than with elective cesarean sections.
• All patients entering the obstetric suite potentially require anesthesia, whether planned or emergent. The anesthetist should therefore be aware of the presence and relevant history of all patients in the suite.
• All women in true labor should be managed with intravenous fluids to prevent dehydration. The minimum fasting period for elective cesarean section should be 6 hours.
• Prophylactic administrations of a clear antacid every 3 h can help maintain gastric pH greater than 2.5 and may decrease the likelihood of severe aspiration pneumonitis.
• Spinal anaesthesia is recommended as the standard procedure for caesarean section. General anaesthesia is used when spinal anaesthesia is contraindicated.
• Oxytocin or syntocinon is the first line agent to help contract the uterus after delivery of the placenta and ergometrine is a second line agent, while prostaglandins are the third line agents if available.