Anaesthetic assessment plays a vital role in the successful management of the pregnant patient with coexisting medical diseases. This has been highlighted by successive reports of the Confidential Enquiries into Maternal Deaths (CEMD). Advances in medical care have resulted in an increasing number of women with concomitant diseases becoming pregnant. The effects of the physiological changes of pregnancy on the disease must be given due consideration in patient evaluation and management. In this review, some of the common problems will be discussed.
A case of instrumental perforation of the oesophagus is presented. This caused systemic sepsis, requiring tracheal intubation and positive pressure ventilation. Sudden unexpected life-threatening airway obstruction was caused by distal tracheal compression by a peritracheal abscess. The aetiology and management of distal tracheal obstruction is discussed.
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