Role of the anaesthetist in the prevention of maternal deaths in Caesarian Section.

The obstetric anaesthetist should not only be skilled in the administration of anaesthesia, but should also have a thorough knowledge of the pharmacology and physiology of pregnancy, labour and delivery and the full implications of the complications that may arise in late pregnancy and during labour. The diagnosis and treatment of these complications are as much his concern as the choice and administration of anaesthetic agents. Such complications which may arise before, during and after Ceasarian Section include prolonged and obstructed labour, inhalation of gastric contents, pre-eclamptic toxaemia and eclampsia, haemorrhage and coagulation disorders, supine hypotensive syndrome and amniotic fluid embolism. Close co-operation between obstetrician and anaesthetist, careful overall management and the judicious choice of drugs in pre-medication, anaesthetic agents and techniques, on the lines outlined and discussed should aid the reduction of meternal mortality in elective and emergency caesarian section to the barest minimum.