Obg

2.  0.75-2% pregnant women undergo surgeries
 Most common indication – acute abdominal
infection
 Appendicitis(1:2000)
 Cholecystitis(8:10000)

3.  Directly related to pregnancy - e.g. Cervical
encirclage
 Indirectly related to pregnancy - e.g.
Ovarian Cystectomy
 Not related to pregnancy -
e.g.Appendicectomy(m.c)

4.  Anaesthesiologist who care for pregnant patient
undergoing non-obstetric surgery must provide
safe anaesthesia for both mother & foetus.
 To maintain maternal safety the physiological
&anatomical changes of pregnancy must be
considered,anaesthetic technique & drug
administration modified accordingly.
 Foetal wellbeing is related to avoidance of
foetal asphyxia& teratogenic drugs & preterm
labour.

5.  Optimization & maintenance of normal maternal
physiological function.
 Optimization & maintenance of uteroplacental
blood flow & 02delivery.
 Avoidance of unwanted drug effects on the
foetus.
 Avoidance of stimulating myometrium.
 Avoidance of awareness during GA.
 Using regional anaesthesia, if possible.
 To prevent hypotension, hypovolemia, hypoxia
and hypothermia

6. Safe
anesthesia
in
pregnancy
Understanding
the altered
pharmacology
Proper
counselling of
the parturient
and family
Understanding
maternal and
fetal
physiology

11.  Teratogenicity is defined as the ability of a drug to cause fetal
abnormalities or deformities.
 During the period of organogenesis the embryo is most
vulnerable to teratogenic effects .

15. TOCOLYTIC DRUGS , MATERNAL
&FETAL SIDE EFFECTS

16. UTEROPLACENTAL PERFUSION &FETAL
OXYGENATION
•Most serious risk during non obstetric surgery
is intrauterine asphyxia.
•Fetal oxygenation depends on maternal
oxygen delivery and uteroplacental perfusion

27. •Advantages