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Neuroanesthesia and pregnancy: Uncharted waters
Shalendra Singh1, Navdeep Sethi2
1Assistant Professor, Department of Anaesthesiology & Critical Care, Armed Forces Medical College, Pune 411040, India.
Medical Journal, Armed Forces India
|May 9, 2019
Summary
Maternal deaths from brain conditions during pregnancy are rising due to non-obstetric causes. Anesthesia management for pregnant patients with brain pathology is challenging due to limited evidence and guidelines.
Area of Science:
- Neuroanesthesia
- Obstetrics
- Maternal Mortality
Background:
- Pregnancy involves significant physiological changes impacting anesthesia.
- Non-obstetric causes of maternal mortality, particularly brain pathology, are increasing.
- Malignant brain tumors and trauma are leading causes of indirect maternal death.
Purpose of the Study:
- To review the current understanding of anesthesia management in pregnant patients with brain pathology.
- To highlight the challenges and paucity of evidence-based guidelines in neuroanesthesia for pregnancy.
Main Methods:
- Literature review of neuroanesthesia in pregnant patients.
- Analysis of trends in maternal mortality related to brain pathology.
- Synthesis of existing case reports and case series.
Main Results:
- An incidence of 30-40 deaths per triennium reported in pregnant patients due to brain pathology.
- Declining obstetric mortality contrasted with a rising trend in non-obstetric mortality.
- Limited evidence-based neuroanesthesia management strategies identified.
Conclusions:
- Anesthesia for pregnant patients with brain pathology is complex due to physiological changes.
- Lack of established guidelines necessitates reliance on limited case data.
- Further research is crucial for developing evidence-based neuroanesthesia protocols for this population.
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