Anaesthetic Contribution to Maternal Mortality

Manual removal of the placenta, Incidence and clinical significance

“…General anesthesia in the treatment of retained placenta should not be used due to potential serious complications such as difficulties with intubation and aspiration as well as the negative psychological effect on the mother and the bonding process (12). In accordance with this, spinal analgesia was introduced as an alternative to general anesthesia during the study period.…”

Laryngeal nerve monitoring during thyroid surgery in pregnancy

“…A review of these deaths from 1979 to 1990 showed that the majority were due to failed intubation and/ or pulmonary aspiration during general anesthesia for Cesarean section [11]. Although most of the complications occurred during general anesthesia for emergency Cesarean sections, some also occurred during elective Cesarean section [11][12][13][14]. The factors that conspire to yield a higher incidence of failed airway management in pregnancy include weight gain, increased intragastric pressure, oropharyngeal edema, enlarged breasts, and decreased functional residual capacity, among others [15].…”

Traditional rapid sequence induction is an outmoded technique for caesarean section and should be modified

“…3 Scott wrote "If we had been honest, the attraction of the new method was the speed and ease with which we could present the intubated paralysed mother to the obstetrician . .…”

“…One group of Italian researchers have compared propofol with thiopental for caesarean section in three studies and on each occasion judged thiopental superior. [2][3][4] Compared with thiopental, propofol was associated with significant maternal hypotension at induction, but perhaps more worryingly, with clinical and electro-encephalographic signs of light anaesthesia between induction and delivery. Recovery scores were no different, but neonatal Dr Tim Meek, Consultant Anaesthetist, James Cook University Hospital, Middlesbrough TS4 3BW, UK, Tel.…”