Operations during pregnancy: how to be with anesthesia?
Expectation of the kid - time pleasant and disturbing, even despite difficulties peculiar to this period and an indisposition. However there can be associated diseases demanding surgeries.
we will note
At once that operation and anesthesia are carried out only according to urgent and emergency indications, in the situations posing threat for mother`s life. If surgical intervention does not demand haste and can be carried out in a planned order, most optimum to wait for the child`s birth, and already then to be hospitalized in hospital for expeditious treatment. But approximately 2% of women during pregnancy have a need for carrying out immediate operation and anesthesia. Most often it interventions in the general surgery and gynecology, stomatology, traumatology.
of Operation at an acute appendicitis
the acute appendicitis, sharp kalkulezny cholecystitis, pankreonekroz, an urolithic illness with violation of outflow of urine and a kidney anthrax are the Most frequent reason of hospitalization of pregnant women in surgical office.
the Acute appendicitis meets frequency of 1 a case on 2000 childbirth. Its diagnostics and treatment in the second and third trimesters of pregnancy are especially difficult. Problems of diagnostics are connected with the fact that the increased uterus displaces internals from their typical places, especially it concerns such mobile part of intestines as an appendix which inflammation is called appendicitis. The appendix during incubation of the baby can move and up to a liver, and down - to bodies of a small pelvis. Besides, nausea, vomiting and some other symptoms can be observed also at normal pregnancy.
Often such future mothers come to a hospital late enough, already with the complicated appendicitis form. At the first stage ultrasonic research and a diagnostic laparoscopy is applied - to be convinced of need of operation. The diagnostic laparoscopy in some situations passes in medical, and in the absence of opportunities in its performance - into a laparotomy, operation with open access.
In a case with appendicitis need for operation in principle is not subject to doubt, but at sharp cholecystitis, a pankreonekroza and diseases of kidneys application of the symptomatic methods of treatment helping to avoid operation or to delay it for the period after the delivery is in most cases possible.
during pregnancy perform Now gynecologic operations extremely seldom. But there are emergency situations at which expeditious treatment is inevitable. Treat them a gap or pereknut ovary cysts, food violation (necrosis) in miomatozny knot, suture on a uterus neck at istmiko - tservikalny insufficiency.Even benign cysts of ovaries can potentially turn out
dangerous to the pregnant woman: in case of growth of a cyst to the big sizes can be observed or a gap, or pereknut an ovary that leads to bleeding, an acute pain and can potentially cause a spontaneous abortion or premature birth. In that case the emergency surgery is surely carried out. At violation of food in miomatozny knots there is optimum term for their removal - it is 16 and more weeks of pregnancy when concentration of the progesterone produced by a placenta increases approximately twice and under its influence sokratitelny activity of a uterus decreases, its tone and excitability decrease, the tensile properties of muscular structures raise and locking function of a neck of a uterus amplifies. All this creates optimum conditions for carrying out operation. Gynecologic operations during pregnancy in most cases are performed by means of a laparoscopy, and in the absence of a possibility of its performance do a nizhnesredinny section that provides the careful and sparing conditions for a fruit. Surgical correction of a neck of a uterus is carried out according to indications under epiduralny anesthesia.Other emergency situations the Emergency stomatologic help to the pregnant woman is given to
in any terms of a gestation taking into account the accompanying pathology and the allergologichesky status of the patient, under local anesthesia, and does not constitute any danger to the woman and health of the kid. And here for planned treatment it is necessary to choose more optimum terms, since 16th week , after final formation of a placenta. During pregnancy implantation of teeth is strictly contraindicated.
Many women during pregnancy become quite awkward, especially last months, and it inevitably increases probability of accidents. It is hard for them to cope with the unusual weight and the changed bearing, and attacks of weakness or dizziness can distract attention at the most inappropriate moment. As a result future mothers continually get small bruises, bruises, dislocations and stretchings, and in certain cases - the serious injuries or changes demanding expeditious treatment.
Anesthesia at pregnancy
the Constant and inseparable fellow traveler of operation is anesthesia. Therefore, speaking about any negative impacts on mother and a fruit, mean influence of both actually surgical intervention, and the chosen anesthesia method. The probability of presence of congenital anomalies at the baby in a situation when mother during pregnancy underwent anesthesia and an operation, is extremely small and comparable to the frequency of development of this pathology in the pregnant women who were not affected by operation and an anesthesia. At anesthesia during pregnancy not the choice of medicine, that is anesthetic, and technology of carrying out anesthesia is of great importance. On safety level for mother and a fruit the choice is most often made in favor of local anesthesia. At impossibility of performance of operation under local anesthesia the following choice has to be made in favor of regionarny (epiduralny) anesthesia. And only in the last turn experts resort to the general anesthesia.
throughout all pregnancy the kid is reliably protected by a layer of amniotic liquid in an amniotic bubble. It means that all troubles which happened to the woman in the family way, most likely, will not be reflected in a state and health of the future of the baby in any way. Surgical methods of treatment and their anesthesia are difficult and dangerous to the pregnant woman, but sometimes not to do without them. Therefore at emergence of the situations demanding surgery it is necessary to trust in professionals who surely will help both mother, and her child.