New Advances In Anesthetic Considerations For Trauma In Pregnancy

Abstract

Pregnancy produces significant physiologic and anatomic changes in every system of the female body. The evaluation of the traumatized pregnant patient, the approach, and the interpretation of the diagnostic tests results must be accompanied by the full knowledge of all changes that take place during pregnancy. In the same context, although the physician treating a pregnant trauma victim must remember that there are two patients, the treatment priorities are the same as for the non-pregnant trauma patient. The best initial treatment for the fetus is the optimum resuscitation of the mother. The obstetrician should be present at all times and be considered a part of the trauma team in the evaluation and treatment of a pregnant trauma patient. Successful outcomes after anesthesia administration for nonobstetric surgery in pregnant patients are dependent on comprehensive preoperative assessment, meticulous attention to detail in relation to maternal and fetal physiology preoperatively, and ongoing supportive care in the postoperative period. Maintenance of maternal stability, optimal timing of surgery, and appropriate selection of anesthetic technique are essential. Although the chief goal in the management of anesthesia is maintenance of uteroplacental perfusion, the role of a multidisciplinary team in the care of high-risk parturient patients cannot be underestimated. Newer surgical techniques have implications for anesthesiologists, and close attention to maternal and fetal parameters is essential to ensure successful outcomes during nonobstetric surgery in pregnant patients. Close communication, especially in relation to timing of surgery and surgical techniques used during the course management, is essential.