Anesthesia for Obstetric Disasters

Kristen L Fardelmann; Aymen Awad Alian

doi:10.1016/j.aan.2020.09.001

Anesthesia for Obstetric Disasters

Adv Anesth. 2020 Dec:38:229-250. doi: 10.1016/j.aan.2020.09.001.

Authors

Kristen L Fardelmann¹, Aymen Awad Alian²

Affiliations

¹ Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA. Electronic address: kristen.fardelmann@yale.edu.
² Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA.

PMID: 34106836
DOI: 10.1016/j.aan.2020.09.001

Abstract

Over the past 30 years, maternal mortality has increased in the United States to 18 deaths per 100,000 live births. Obstetric emergencies, including hemorrhage, hypertensive disorders in pregnancy, HELLP syndrome, and amniotic fluid embolism, and anesthesia complications, including high neuraxial blockade, local anesthetic systemic toxicity, and the difficult obstetric airway, contribute to maternal cardiac arrest and maternal and fetal morbidity and mortality. Expeditious intervention by the obstetric anesthesiologist is critical in these emergent scenarios, and knowledge of best practices is essential to improve maternal and fetal outcomes.

Keywords: Amniotic fluid embolism; HELLP syndrome; High neuraxial blockade; Local anesthetic systemic toxicity; Maternal cardiac arrest; Maternal mortality; Postpartum hemorrhage.

Publication types

Review

MeSH terms

Anesthesia, Obstetrical / methods*
Female
Heart Arrest / physiopathology*
Humans
Maternal Mortality*
Pregnancy
Pregnancy Complications / physiopathology*