Anesthesia for the pregnant patient undergoing nonobstetric surgery

Summary There are, therefore, a multitude of concerns that require consideration with regard to providing anesthesia care for the pregnant patient undergoing surgery. However, the basic considerations common to all such cases are the following: (1) The physiologic changes of pregnancy must be understood and the anesthetic implications thereof must be acted upon. (2) Maternal blood pressure and uteroplacental perfusion must be maintained. Hypotension and aortocaval compression should be avoided; however, if these should occur, treatment should be instituted promptly. (3) Anesthetic techniques should be selected that limit the exposure of mother and fetus to potentially teratogenic agents; remembering, however, that no anesthetic agent has yet been proved to be teratogenic in man. Regional anesthesia should be used whenever possible. (4) Preoperatively, discuss with the patient the implications of surgery and anesthesia during pregnancy, including our current knowledge regarding the lack of known teratogenicity of anesthetic agents. (5) Fetal heart rate and uterine activity should be monitored intraoperatively and postoperatively; if changes are noted, the anesthetic technique should be modified accordingly.