Obstetric emergencies and anaesthesia

Abstract

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].