[Acute fetal distress. The anesthesiologist's point of view].
Foetal distress is a non-specific and imprecise diagnose sometimes associated with surgical delivery of a normal newborn. As this type of delivery is usually considered urgent, emergent anaesthesia is required. General anaesthesia is usually chosen in these cases because it is the quickest anaesthetic technique and because of fears concerning the haemodynamic consequences of regional techniques. Maternal risks of general anaesthesia which is the leading cause of anaesthesia-related maternal mortality (difficult intubation and Mendelson's syndrome) but also neonatal consequences (increased need for neonatal resuscitation) have challenged this policy. Indeed, spinal anaesthesia and extension of a pre-existing epidural analgesia are more and more used during emergency Caesarean section. A better evaluation of the patient's problems based upon a pre-anaesthetic outpatient visit during the last trimester of pregnancy allows a more rational approach to meet the patient's requirements should an emergency. Caesarean section be necessary. For example, a "prophylactic" epidural instituted soon after the beginning of labour may be lifesaving in a patient with obvious signs of difficult intubation. A clear definition of safe standards of equipment and practices either to prevent. Mendelson's syndrome or to cope with a failed intubation drill is of greatest importance. Finally, comprehensive communication between the anaesthetic and obstetrical teams is one of the most useful ways to facilitate safer approach of the management of obstetric emergencies studies. Caesarean section for foetal distress.
Hamza
J
J
Département d'Anesthésie-Réanimation, Hôpital Saint-Vincent-de-Paul, Paris.
D000208:Acute Disease; D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D002585:Cesarean Section; D003663:Decision Trees; D004630:Emergencies; D005260:Female; D005316:Fetal Distress / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods; D011187:Posture; D011247:Pregnancy