Tocolytic drugs are discussed elsewhere, but during operative delivery and fetal surgery the anaesthetist may be required to provide acute tocolysis. Arguably, volatile anaesthetic drugs are the most effective acute tocolytics, but by definition they induce unconsciousness and thus general anaesthesia. Intravenous alternatives are available, and can be used with regional anaesthesia, but they must beused with caution and appropriatemonitoring lest cardiovascular collapse occur. As outlined above, GA, and optimal tocolysis are often preferred for complex surgery involving uterine manipulations, and some multiple pregnancy deliveries, for example, conjoined or monoamniotic twins.
In summary, modern obstetrics includes anaesthetic procedures for most parturients. Close cooperation, consultation and planning, minimal use of general anaesthesia, especially in emergency situations have markedly reduced maternal and perinatal mortality and morbidity, and will continue to do so. All expectant mothers may require analgesia or anaesthesia, so risk factors must be sought and acted upon antenatally to maintain the impressive record of safety of anaesthesia in obstetrics.
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Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.