General information
It happens that general anesthesia cannot be avoided in women who are pregnant. The planning and execution of these non-gynaecological procedures is carried out by the treating anaesthetist. A total of 0.5%-1.6% of all pregnant women undergo such an operation every year.
General anesthesia and the associated surgical intervention during pregnancy always pose a certain risk for the mother as well as the child, which is why the decision to undergo such an intervention should never be taken lightly. General anesthesia ensures that no pain can be felt during a surgical procedure and that the patient is not conscious. It also eliminates vegetative reflexes and relaxes the muscles of the body.
All medications used for general anesthesia are common to placenta and thus also reach the fetus. Whether the drugs can harm the development of the child is currently being investigated and is not yet known for sure. In the animal model, a connection between anaesthesia received in childhood and a learning disability occurring later on was found. However, retrospective studies have so far only partially confirmed this connection.
Special features of anesthesia during pregnancy
General anesthesia in a pregnant woman is always a challenge for the treating team, because instead of the usual one patient, now the responsibility for two patients must be taken over. At the same time, some biological changes take place during pregnancy, which must be taken into account when performing an anaesthetic. The changes of the respiratory organs are a particularly important part during the monitoring of anesthesia.
It is important to supply the mother and thus the child with sufficient oxygen, otherwise damage to the child cannot be ruled out. Paradoxically, an oversupply of oxygen to the mother is counterproductive for the supply of the fetus, because if there is too much oxygen in the mother’s blood, less oxygen reaches the child via the placenta. The changes in the respiratory organs mean that the anaesthetic gases act more quickly, but can also escape from the body more quickly when the drugs are discontinued.
At the same time, there is increased blood flow to the mucous membranes, which is difficult to secure the airways by intubation. Bleeding is more frequent, or the airways must be secured in these cases by other means. Pregnancy also leads to changes in the cardiovascular and vascular system. The blood volume and pulse rate increase during pregnancy. At the same time, the mother’s blood pressure also increases.
