Anaesthesia for non obstetric surgery during pregnancy

A significant number of women undergo anesthesia and surgery during pregnancy for procedures unrelated to delivery. In order to provide safe anaesthesia for mother and fetus, it is essential for the anesthetist to have thorough understanding of the physiological and pharmacological changes that characterize the three trimesters of pregnancy. A multidisciplinary team approach involving the anesthetist, obstetrician, neonatologist and surgeon is highly recommended to ensure an adequate standard of care. Anaesthesia management, including post-operative analgesia, should be planned well to preserve the pregnancy and to ensure the safety of the mother as well as the foetus. Once fetal viability is assumed (24-26 weeks), the fetal heart rate (FHR) should be monitored. Regional anaesthesia minimizes fetal drug exposure, airway management is simplified, blood loss may be decreased, and overall risks to the mother and fetus are less.