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Enfoques anestésicos para presentación anómala y gestación múltiple

Oscar F C van den Bosch1, Feline F J A Ter Bruggen1, Erica M Johnson2

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Current opinion in anaesthesiology
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Resumen

Los anestesiólogos deben estar preparados para la versión cefálica externa (VCE) y la analgesia del parto en casos de presentación anómala y gestación múltiple. La cesárea en gestaciones múltiples aumenta el riesgo de hemorragia posparto, lo que requiere una atención vigilante.

Palabras clave:
pelvianapresentación anómalagestación múltipleanestesia obstétrica

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Área de la Ciencia:

  • Obstetricia y Anestesiología
  • Medicina Materno-Fetal

Sus antecedentes:

  • La presentación anómala y la gestación múltiple presentan desafíos anestésicos únicos.
  • Las prácticas anestésicas actuales requieren actualizaciones basadas en evidencia reciente.

Objetivo del estudio:

  • Revisar las consideraciones anestésicas para la presentación anómala y la gestación múltiple.
  • Cubrir la analgesia para la versión cefálica externa (VCE), el parto y la cesárea.
  • Discutir la gestión del riesgo de hemorragia posparto.

Principales métodos:

  • Revisión de la literatura sobre el manejo anestésico en la presentación anómala y la gestación múltiple.
  • Análisis de hallazgos recientes sobre analgesia neuroaxial y riesgos de la cesárea.

Principales resultados:

  • La analgesia neuroaxial mejora el éxito de la VCE y la comodidad materna.
  • La analgesia neuroaxial para el parto mejora la seguridad en los partos vaginales de gestaciones múltiples.
  • La cesárea en gestaciones múltiples presenta un mayor riesgo de atonía uterina y una mayor necesidad de oxitocina.

Conclusiones:

  • Los anestesiólogos deben estar atentos a los casos de presentación anómala y gestación múltiple.
  • Las brechas entre la evidencia y la práctica exigen estudios de implementación y directrices.