Anaesthesia for non-obstetric procedures during pregnancy
Pregnancy causes many changes in a woman's body, which can affect how anaesthesia is given. While non-urgent surgeries are usually delayed until after childbirth, some emergencies require immediate surgical intervention. The goal of anaesthesia during pregnancy is to ensure the safety of both the mother and the baby.
When is Surgery Needed During Pregnancy?
Sometimes, pregnant women need surgery for conditions unrelated to pregnancy. Common reasons include appendicitis, gallbladder disease, injuries, ovarian cysts, heart problems, and certain cancers. In such cases, anaesthesia must be carefully managed to avoid risks.
How Pregnancy Affects Anaesthesia
Pregnancy changes how the body responds to anaesthesia. The lungs work harder, and oxygen levels can drop faster, increasing the risk of breathing difficulties. The heart pumps more blood, making blood pressure harder to control. The stomach empties slower, increasing the risk of vomiting and aspiration during surgery. Blood clotting is also more active, raising the risk of complications after surgery.
Choosing the Right Anaesthesia
Doctors choose anaesthesia carefully to protect both mother and baby. Whenever possible, regional anaesthesia, such as an epidural or spinal block, is preferred because it avoids putting the mother to sleep and limits drug exposure to the baby. When general anaesthesia is necessary, extra precautions are taken to ensure proper breathing and reduce risks.
Safe Anaesthetic Medications
Some anaesthesia drugs are safer for pregnant women. Propofol, fentanyl, and sevoflurane are commonly used because they have minimal effects on the baby. However, some drugs, like benzodiazepines and nitrous oxide, should be used cautiously. Continuous monitoring of the baby’s heart rate during surgery is essential, especially after 24 weeks of pregnancy.
Managing the Airway and Preventing Aspiration
Pregnancy-related swelling can make it harder to place a breathing tube, so careful planning is needed. To reduce the risk of stomach contents entering the lungs, doctors use medications to lower stomach acid and perform a rapid induction technique for general anaesthesia. Positioning the mother slightly on her left side helps maintain proper blood flow to the baby.
Recovery and Post-Surgery Care
After surgery, both mother and baby need close monitoring. Doctors watch for signs of preterm labor and ensure the mother receives adequate pain relief without harming the baby. A combination of different pain management methods helps keep both mother and child comfortable and safe.
Conclusion
Whenever possible, elective surgeries should be delayed until after childbirth. If surgery is unavoidable, careful anaesthetic planning ensures the best possible outcome. Regional anaesthesia is often preferred, but general anaesthesia can be safely used when necessary. With a team approach involving obstetricians, anaesthesiologists, and surgeons, non-obstetric surgeries can be performed safely, protecting both the mother and the developing baby. At KKCTH, we prioritize the highest standards of care for pregnant women requiring anaesthesia. Come visit us for expert consultation and safe medical care.
