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Choice of Anesthesia for Labor and Delivery

From the Departments of Anesthesia and of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California

Abstract

Skillful administration of a well-chosen anesthetic can ease the birth process for the mother, and can possibly prevent such signs of stress in the fetus as bradycardia and asphyxia, which are caused by uterine vasoconstriction. This survey summarizes current knowledge of physiologic changes in pulmonary, cardiac, renal, and other functions during pregnancy and childbirth and the ways in which anesthesia may affect them. Indications and contraindications for the use of various types of anesthesia in normal and complicated deliveries are discussed, as are ways to prevent or minimize adverse reactions in mother and child. This summary facilitates the practicing obstetrician's understanding of the techniques, advantages, and problems involved with obstetric anesthesia and analgesia.