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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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.