Anesthesia for the high-risk parturient.
High-risk pregnancies require specialized obstetric and anesthetic care. A basic understanding of how specific pathophysiology and pharmacologic therapy interact with anesthetic care is essential for both obstetrician and anesthesiologist. This paper selectively focuses on preeclampsia/eclampsia, diabetes mellitus, prematurity, multiple gestations, infectious disease, preexisting neurologic disease, and preexisting cardiac disease, reviewing anesthesia for labor and vaginal and cesarean delivery for each high-risk problem, as practiced at a Level III perinatal unit. Emphasis will be placed, when appropriate, on recent experience with monitoring and aggressive pharmacologic therapy of the critically ill parturient.
D000698:Analgesia / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods*; D004347:Drug Interactions; D005260:Female; D006331:Heart Diseases / Q000628:therapy; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D009422:Nervous System Diseases / Q000628:therapy; D007752:Obstetric Labor, Premature / Q000628:therapy; D010920:Placenta / Q000098:blood supply; D011015:Pneumonia, Aspiration / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011254:Pregnancy in Diabetics / Q000628:therapy; D011272:Pregnancy, Multiple; D012039:Regional Blood Flow; D012306:Risk; D014599:Uterus / Q000098:blood supply