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1、急診剖宮產(chǎn)的 麻醉選擇和術(shù)中處理費(fèi)敏2010-3-26DefinitionAbdominaldeliveryasurgicalprocedurethatpermitsdeliveryoftheinfantthroughincisionsintheabdominalanduterinewall.CesareanSectionCaedere–SecoPompiliusII730BCnotwidelyuseduntilthe1920sIndicationsforCesareanSectionRepeatScheduledFailedattemptatvaginaldeli
2、veryDystociaAbnormalpresentationTransverselieBreechMultiplegestationFetalstress/distressDeterioratingmaternalmedicalillnessPreeclampsiaHeartdiseasePulmonarydiseaseHemorrhagePlacentapreviaPlacentalabruptionCesareanSection>60%unplannedMoreextensiveperipartummonitoringLowerthresholdforsur
3、gicalinterventionWhatisan‘emergency’Caesareansection?-Category1&2GradeDefinition(attimeofdecisiontooperate)Category1ImmediatethreattolifeofwomanorfetusCategory2Maternalorfetalcompromise,notimmediatelylife-threateningCategory3NeedingearlydeliverybutnomaternalorfetalcompromiseCategory4At
4、atimetosuitthewomanandmaternityteamCategory1IndicationPlacentalabruptionuterinerupturecordprolapseActivelybleedingplacentapraeviaIntrapartumhemorrhagePresumedfetalcompromisewithseverelyabnormalCTGand/orseverefetalacidosisThe30-minuteruleamaximumdecision-to-deliverytimeof30minforCategor
5、y1situationAssociationofAnaesthetistsofGreatBritainandIrelandandObstetricAnaesthesists’Association.Guidelinesforobstetricanaesthesiaservices;2005.HillemannsP,StraussA,HasbargenU,etal.Crashemergencycesareansection:decision-to-deliveryintervalunder30minanditseffectonApgarandumbilicalarte
6、rypH.ArchGynecolObstet2005;273:161–165.anaesthetistinformed–deliveryPerianestheticEvaluationAdirectedhistoryandphysicalexaminationplateletcountAnintrapartumbloodtypeandscreenforallparturientsreducesmaternalcomplicationsPerianestheticrecordingofthefetalheartratereducesfetalandneonatalco
7、mplicationsAdirectedhistoryandphysicalexaminationMaternalhealthandanesthetichistoryRelevantobstetrichistoryAirwayandheartandlungexaminationBaselinebloodpressureBackexaminationwhenneuraxialanesthesiaisplannedorplacedPlateletcountAroutineintrapartumplateletcountdoesnotreducematernalane
