No longer rare diseases and obstetric anesthesia

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Maternal-Fetal Medicine

Background:

• Maternal demographics are shifting due to medical advancements and lifestyle changes.
• An increasing number of older and medically complex women are pursuing pregnancy.
• High-risk parturient populations are becoming more prevalent in obstetric practice.

Purpose of the Study:

• To review and present the diverse high-risk parturient populations encountered in modern obstetric anesthesia.
• To inform obstetric anesthesiologists about the evolving landscape of high-risk pregnancies.
• To discuss the implications of changing maternal demographics on clinical practice.

Main Methods:

• Literature review of current trends in high-risk pregnancies.
• Synthesis of data on demographic shifts and associated medical conditions.
• Discussion of previously rare parturient populations now seen more frequently.

Main Results:

• Older women face increased pregnancy complications.
• Pregnant cancer survivors and those diagnosed during pregnancy are more common.
• Pre-existing neurological and cardiac conditions are increasingly managed during pregnancy.
• Rising obesity rates correlate with increased obstructive sleep apnea, posing maternal and neonatal risks.
• Increased use of opioids and marijuana presents challenges in managing substance use during pregnancy.

Conclusions:

• Further research is essential for understanding and managing these complex cases.
• Implementation of international guidelines is crucial for reducing maternal and neonatal morbidity.
• Proactive management strategies are needed for the evolving high-risk parturient population.