Obstetrics Yao Flashcards
What are the leading causes of maternal mortality,
and what role does anesthesia play in this mortality?
○ Nearly 75% of all maternal deaths are due to severe bleeding, infections, hypertensive disorders of pregnancy, delivery complications,and unsafe abortions.
○ The remainder of deaths are caused by orassociated with diseases such as malaria and AIDS during pregnancy
Define maternal mortality ratio
The WHO defines the maternal mortality ratio (MMR) as the
number of direct and indirect maternal deaths per 100,000 live
births; it does not include late maternal deaths occurring more
than 42 days but less than 1 year after pregnancy termination.
In developed regions, the estimated anesthesia-related MMR
ranges between 1 and 3 deaths per 1,000,000 live births.
If a
maternal death can be attributed to an anesthetic complication
and if an ideal anesthetic would have likely avoided this death,
the death is considered anesthetic related
Looking at 257,000
parturients receiving neuraxial or general anesthesia between
2004 and 2009, the Serious Complication Repository Project of
the Society for Obstetric Anesthesiology and Perinatology found
that approximately 1 of 3,000 patients had serious anesthesia-
related complications with high neuraxial block; respiratory
arrest in the labor suite and unrecognized spinal catheters were
the most common of these complications. In low- and middle-
income countries, however, about 1 in 7 maternal deaths during
or after cesarean section were due to anesthesia, which is a very
high mortality rate compared with that in developed countries.
What is the differential diagnosis for an antepartum
hemorrhage?
The most common causes of antepartum
hemorrhage are placenta previa and placental abruption
Rare causes of antepartum bleeding include velamentous
insertion of the umbilical cord with the involved placental
vessels overlying the cervix, which is known as vasa previa,
uterine rupture, cervicitis, and local genital tract lesions.
How would you diagnose the etiology of antepartum
bleeding after midpregnancy?
