Physiological changes in the pregnant woman and anesthesiologist´s approach
DOI:
https://doi.org/10.30445/rear.v13i5.915Keywords:
Anesthesia, Pregnancy, deliveryAbstract
The need of both urgent and non-delayable elective surgery can emerge at any moment during pregnancy. In these cases, such interventions require a considerable effort and an added stress for the Anesthesiology specialist, who must thoroughly monitor and take care of not one, but two lives (that of the mother and of the fetus) with many particularities. Moreover, gestation, as well as labor and delivery, involve a series of physiological changes in the pregnant woman, that modify the organism´s response to anesthetic drugs and therefore imply changes in the handling of such drugs.
The aim of this article is to summarize the main changes associated with pregnancy and their subsequent implications, in order to offer a global vision on the anesthetic management of pregnant women during both non-obstetric surgery and delivery.
References
- Warner M.D. MA, Warner M.D. ME, Weber M.D. JG. Clinical Significance of Pulmonary Aspiration during the Perioperative Period. Anesthesiol J Am Soc Anesthesiol 1993; 78: 56–62.
- Neelakanta G, Chikyarappa A. A review of patients with pulmonary aspiration of gastric contents during anesthesia reported to the Departmental Quality Assurance Committee. J Clin Anesth 2006; 18: 102–107.
- Birgitta Norstedt Wikner MD1*, Carl-Olav Stiller MD, PhD1,Ulf BergmanMD, PhD2, Charlotte Asker MD, PhD1 and Bengt Ka¨lle´nMD P. Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformationsy Birgitta. Pharmacoepidemiol Drug Saf 2007; 16: 228–228.
- Dolovich LR, Addis A, Vaillancourt JMR, et al. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies Lisa. Methods 1998; 317: 839–843.
- Devroe S, Bleeser T, Van de Velde M, et al. Anesthesia for non-obstetric surgery during pregnancy in a tertiary referral center: a 16-year retrospective, matched case-control, cohort study. Int J Obstet Anesth 2019; 39: 74–81.
- Jenkins TM, Mackey SF, Benzoni EM, et al. Non-obstetric surgery during gestation: Risk factors for lower birthweight. Aust New Zeal J Obstet Gynaecol 2003; 43: 27–31.
- Datta S, Lambert DH, Gregus J, et al. Differential sensitivities of mammalian nerve fibers during pregnancy. Anesth Analg 1983; 62: 1070–1072.
- Mongardon N, Servin F, Perrin M, et al. Predicted propofol effect-site concentration for induction and emergence of anesthesia during early pregnancy. Anesth Analg 2009; 109: 90–95.
- WHITTAKER M, CRAWFORD JS, LEWIS M. Some observations of levels of plasma cholinesterase activity within an obstetric population. Anaesthesia 1988; 43: 42–45.
- Et T, Topal A, Erol A, et al. The effects of sugammadex on progesterone levels in pregnant rats. Balkan Med J 2015; 32: 203–207.
- McCann ME, Berde C, Soriano S, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial. Lancet 2019; 393: 664–677.
- Sun LS, Li G, Miller TLK, et al. Association between a single general anesthesia exposure before age 36 months and neurocognitive outcomes in later childhood. JAMA - J Am Med Assoc 2016; 315: 2312–2320.
- Schroeder DR, Hanson AC, Schulte PJ, et al. Neuropsychological and Behavioral Outcomes after. Anesthesiology 2018; 129: 89–105.
- U.S. Food and Drug Administration. Drug Safety and Availability - FDA Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. Drug Saf Availab - FDA Drug Saf Commun FDA Rev results new Warn about using Gen Anesth Sedat drugs young Child pregnant women 2016; 1–11.
- Surgery N, Pregnancy D. ACOG Committee Opinion No. 775 Summary. Obstet Gynecol 2019; 133: 844–845.
- US Food and Drug Administration. FDA Drug Safety Communication: FDA approves label changes for use of general anesthetic and sedation drugs in young children. 2017; 1–2.
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