Obstetric emergencies and anaesthesia

  • H. Singh
  • R. Alexander
Conference paper


In the generally accepted sense of the term, life-threatening conditions imply illnesses that will inevitably lead to death without immediate medical intervention. Many anaesthetists fear obstetric emergencies, because these are some of the most extreme challenges of their professional lives. Obstetric emergencies can be life-threatening to the mother-to-be, the fetus or both. Worldwide, the commonest causes of the maternal mortality are pre-eclampsia, haemorrhage, cardiac disease and sepsis. While critical illness requiring admission to intensive care units (ICUs) are uncommon in pregnancy, accounting for between 1 and 9 per 1,000 deliveries [1–5], mortality can be as high as 20%, depending upon the severity of illness and entry requirement to ICU. The majority of admissions to general, surgical, or obstetric ICUs are due to obstetric complications rather than intercurrent medical disease. Of obstetric complications, hypertensive diseases of pregnancy and obstetric haemorrhage make up the majority of problems [4]. Anaesthetic complications can account for 13% of admissions [1].


Epidural Analgesia Mitral Valve Stenosis Obstetric Complication HELLP Syndrome Neonatal Resuscitation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Graham SG, Luxton MC (1989) The requirement for intensive care support for the pregnant population. Anaesthesia 44: 581–584PubMedCrossRefGoogle Scholar
  2. 2.
    Kilpatrick S, Mathey M (1990) Obstetric patients requiring critical care. Chest 101: 1407–1412CrossRefGoogle Scholar
  3. 3.
    Collop N, Sahn S (1993) Critical illness in pregnancy. Chest 103: 1548–1552PubMedCrossRefGoogle Scholar
  4. 4.
    Umo-Etuk J, Lumley J, Holdcraft A (1996) Critically ill parturient women and admission to intensive care: a 5 year review. International Journal of Obstetric Anaesthesia 5: 79–84CrossRefGoogle Scholar
  5. 5.
    Lapinsky S, Kruczynski K, Seaward G et al (1997) Critical care management of the obstetric patient. Canadian Journal of Anaesthesia 44: 325–329PubMedCrossRefGoogle Scholar
  6. 6.
    Knight M, Duley L, Henderson-Smart DJ et al (2003) Antiplatelet agents for preventing and treating pre-eclampsia (Cochrane review: The Cochrane library issue 2 ) Update Software, OxfordGoogle Scholar
  7. 7.
    The Magpie Trial Collaboration Group (2002) Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet 359: (9321)1877–1890Google Scholar
  8. 8.
    Jouppila P, Jouppila R, Holimen A et al (1982) Lumbar epidural analgesia to improve intervillous blood flow during labour in severe pre-eclampsia. Obstet Gynecol 59: 158–161PubMedGoogle Scholar
  9. 9.
    Zornberg GL, Jick H (2000) Antipsychotic drug use and risk of first time idiopathic venous thromboembolism: a case control study. Lancet 356: 1219–1223PubMedCrossRefGoogle Scholar
  10. 10.
    Royal College of Obstetricians and Gynaecologists (2001) Thromboembolic disease in pregnancy and the puerperium: acute management (guideline no. 28 ). RCOG, LondonGoogle Scholar
  11. 11.
    Waterstone M, Bewley S, Wolfe C (2001) Incidence and predictors of severe obstetric morbidity: case control study. BMJ 322: 1089–1093PubMedCrossRefGoogle Scholar
  12. 12.
    Rainaldi MP, Tazzari PL, Scagliarini G et al (1998) Blood salvage during caesarean section. BJA 80: 195–198PubMedCrossRefGoogle Scholar
  13. 13.
    Gei A, Hankins GDV (2001) Cardiac disease and pregnancy. Obstet Gynecol Clin North Am 28: 465–512PubMedCrossRefGoogle Scholar
  14. 14.
    Barnardo PD, Jenkins JG (2000) Failed tracheal intubation in obstetrics: a 6 year review in a UK region. Anaesthesia 55: 685–694CrossRefGoogle Scholar
  15. 15.
    Rees GA, Willis BA (1988) Resuscitation in late pregnancy. Anaesthesia 43: 347–349PubMedCrossRefGoogle Scholar
  16. 16.
    Katz VL, Dotters DJ, Droegemueller W (1986) Perimortem caesarean delivery. Obstet Gynecol 68: 571–576PubMedGoogle Scholar
  17. 17.
    American College of Obstetrician and Gynecologists (1998) Inappropriate use of the terms fetal distress and birth asphyxia. ACOG Committee Opinion, ACOG, Washington DCGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 2004

Authors and Affiliations

  • H. Singh
  • R. Alexander

There are no affiliations available

Personalised recommendations