Cerebral Monitoring in Obstetrics

Abstract

SUMMARY P atients undergoing different surgical procedures have increased risk of ischemic/hypoxic damage to the central nervous system (CNS). This risk may be related to hemodynamic/embolic events. This fact has made the availability of direct, timely feedback about the effects of surgery on nervous system function and the adequacy of its blood supply a crucial issue and raised attention to the importance of cerebral monitoring for different surgical procedures during anesthesia especially during pregnancy and labor through microdialysis and transcranial Doppler to asses difference between eclamptic pregnant and non-pregnant. In general the brain can be monitored in terms of: 1. Function: by studying changes in cortical electirical activity or studying the electrical activity along sensory or motor pathways which mirrors brain response and functional integrity of different sensory and motor pathways to different anesthetic. 2. Blood flow: depending on lots of modalities each of which has its own advantages and disadvantages as regard its efficiency in reflecting either global or regional changes in cerebral blood flow in response to different anesthetic agents during different surgical procedures with high impact on management and outcome of such changes. 3. Cerebral oxygenation: which has its impact on the proper timing of intervention whenever impaired brain oxygenation occurs during different surgical procedures. 4. Microdialysis: which reflects brain metabolic status under effect of anesthesia. 5. Intracranial pressure: which aids in maintaining intracranial pressure (ICP) within ranges that doesn't interfere with cerebral perfusion pressure (CPP). 6. Transcranial Dopplar: detecting flow veloicity in cerebral circulation.