Complications of anesthesia resuscitation in obstetrics

The article was professionally consulted by Specialist Doctor I Nguyen Xuan Tinh - Anesthesiologist - Resuscitation - Department of General Surgery - Vinmec Phu Quoc International General Hospital. The doctor has more than 18 years of experience studying and working in the field of Anesthesia - Resuscitation.

Complications of anesthesia in obstetrics resuscitation may arise from underlying medical conditions or may also result from the invasiveness of surgical procedures. These complications can occur during pre-anesthesia, induction, maintenance, release (recovery) and postoperative period.

Anesthesia is a method that helps patients not feel pain with varying degrees of awakening. Anesthesia method also helps maintain stable vital functions when the doctor performs a surgery or procedure. The method of anesthesia will help the patient lie still, without pain, without moving, making the surgery process go smoothly and especially to ensure the safety of the patient.
Resuscitation is the diagnostic and treatment measures for surgical patients to maintain, stabilize and improve vital functions. Thanks to the means of monitoring, cardiovascular and respiratory support and the use of resuscitative drugs, it will help to correct disorders of the patient's living functions.
Therefore, anesthesia during surgery and procedures is essential because pain and fear will lead to reflex cardiac arrest for the patient. Anesthesia and resuscitation always go together to contribute to a successful surgery. Especially in patients with concomitant chronic diseases (high blood pressure, cardiovascular disease, diabetes, kidney failure...) anesthesia and resuscitation play an extremely important role.

Anesthesia plays a very important role in obstetrics. However, resuscitation anesthesia can also cause very dangerous complications. Complications of anesthesia in obstetrics resuscitation may arise from underlying medical conditions of the patient, or may also result from the invasiveness of surgical procedures or from complications of anesthesia.
Obstetric complications in anaesthesia can occur during the pre-anesthesia, induction, maintenance, anesthesia release (recovery) and postoperative period. Complications of anesthesia resuscitation in obstetrics include:
Pre-anesthesia phase:
Complications of anesthesia resuscitation that can be encountered during this period are respiratory depression. This is because anesthetic agents have a respiratory depression effect and these drugs are more sensitive in the elderly and young children; Cardiovascular collapse: This complication is common in people who are prone to dehydration, severe electrolyte loss and prolonged protein deficiency. In particular, this complication of obstetric resuscitation occurs when pre-anesthesia with sympathomimetic drugs is used because it is easy for cardiovascular collapse when changing positions. Stage of induction of anesthesia:
Complications of apnea: The cause leading to apnoea complications in obstetrics resuscitation is due to high concentration intravenous anesthetic injection, rapid injection and muscle relaxant, patients holding their breath for a long time. . Asphyxia: Caused by upper airway obstruction by sputum production, laryngospasm and tracheobronchial constriction, tongue retraction pressing on the glottis, vomiting, and blood and foreign bodies. Cardiac arrest: The cessation of the heart muscle, resulting in no blood flow. Blood will not flow to vital organs, cannot supply oxygen, leading to death if not treated. Hypotension: The cause leading to complications of hypotension during induction of anesthesia is inadequate fluid resuscitation or the effects of some anesthetic drugs. Vomiting: Caused by stomach stagnation of food. This obstetric complication is common during emergency surgery.

Anesthesia maintenance phase:
Lack of oxygen: Complications of anesthesia in this obstetrical resuscitation are caused by factors that obstruct or obstruct the upper respiratory tract, poor artificial respiration,... Excess CO2: Complications This is also mainly due to factors that obstruct or obstruct the upper respiratory tract, not good artificial respiration,... Other complications such as: hypothermia, cardiac arrest, fast or slow pulse, hiccups, etc. .. are also possible complications. Phase out of anesthesia:
Complications of vomiting: The cause of this complication is that after anesthesia, the effect of anesthetic drugs is still there, so the patient often vomits or the process of aspirating gastric juice does not go away. Upper respiratory tract obstruction: The cause of upper airway obstruction is due to tongue drop, tongue pressing on the glottis,... Cardiovascular collapse: May be due to excess CO2 in the post-anesthesia stage, blood loss due to insufficient compensation and because the movement is not gentle. See more: Diet after cesarean section: Don't be too strict

Obstetric complications are very dangerous complications, obstetric complications can occur during pregnancy, labor, miscarriage or premature birth or possibly in the postpartum period. Obstetric complications are very dangerous because they are unpredictable, threatening the safety of mother and baby. Obstetric complications can follow as follows:
Amniotic fluid embolism: This is the infiltration of amniotic fluid, fetal cells, debris or fetal hair into the maternal blood vessels through the placenta. in the uterus. This complication is considered the most dangerous in obstetrics, saying this complication is most dangerous because it happens very quickly and unexpectedly, cannot be prevented in advance, so it causes allergic reactions, acute cardiopulmonary failure. and severe bleeding. About 50% of pregnant women die if they experience complications of amniotic fluid embolism. Uterine rupture: Uterine rupture can be life-threatening for both mother and fetus. When the mother's uterus is ruptured, the fetus will die and if not treated promptly, the pregnant woman will also be in danger. This obstetric complication usually occurs in the case of too large or abnormal fetal position, incision in the uterus... Postpartum haemorrhage: Postpartum hemorrhage is an obstetric complication that usually occurs within 24 hours. early after childbirth. This complication, if not actively treated, will cause maternal death. Eclampsia, preeclampsia: These are complications of hypertensive disorders in pregnancy. This obstetric complication usually occurs during the third trimester of pregnancy. Postpartum infection: Postpartum infection occurs in a woman after giving birth. Postpartum infections can arise from the vagina, cervix, or uterus during the first 6 weeks after giving birth. Postpartum infection will affect the health and life of the mother. Neonatal Tetanus: This complication is a condition in which the central nervous system of an infant is poisoned by the tetanus toxin Clostridium tetani. This toxin will enter the child's body through the umbilical cord, cut the umbilical cord with a tool containing tetanus spores due to not being cleaned and sterilized according to medical procedures. Although medical research has studied resuscitation methods to treat neonatal tetanus, neonatal tetanus still has a mortality rate of up to 80% Any mother is at risk of obstetric complications, because Therefore, the prevention of obstetric complications plays an important role in ensuring the health of mother and baby..
See also: Classification of postpartum infections and treatment regimens

To prevent complications in obstetrics, the most important method is to have regular antenatal check-ups to detect risks and abnormalities if any. At the same time, pregnant women should:
Get vaccinated against tetanus fully and on schedule. Supplement with iron, calcium, and vitamins exactly as prescribed by your doctor. Have a diet as well as rest, light and reasonable labor. When you see signs of abdominal pain, vaginal discharge, vaginal bleeding or headache, dizziness, dizziness... you need to come immediately. medical facilities for timely examination and treatment. To ensure safety during childbirth and no complications during anesthesia, pregnant women need to choose a reputable hospital with a team of highly specialized doctors and a system of modern equipment. Currently, Vinmec International General Hospital is one of the hospitals that strictly applies safe surgical anesthesia practice standards according to international guidelines. Vinmec has a team of experienced anesthesiologists and nurses, modern equipment such as: nerve detectors, ultrasound machines, Karl Storz's difficult airway control system, comprehensive anesthesia monitoring system GE's AoA (Adequate of Anesthesia) including monitoring of anesthesia, pain and muscle relaxation will provide high quality and safety, helping patients to have adequate anesthesia, not wake up, and do not have residual muscle relaxants after surgery.
Vinmec Health System is also proud to be the first hospital in Vietnam to sign with the World Anesthesiology Association (WFSA) towards the goal of becoming the safest hospital for surgical anesthesia in Southeast Asia.