Document Detail

Anaesthesia chapter from Saving mothers' lives; reviewing maternal deaths to make pregnancy safer.
MedLine Citation:
PMID:  18070784     Owner:  NLM     Status:  MEDLINE    
This chapter concerning maternal mortality due to anaesthesia, reprinted with permission from Saving Mothers' Lives, is the 18th in a series of reports within the Confidential Enquiries into Maternal and Child Health (CEMACH) in the UK. In the years 2003-05 there were six women who died from problems directly related to anaesthesia, which is the same as the 2000-02 triennium. Obesity was a factor in four of these women who died. Two of these deaths were in women in early pregnancy, who received general anaesthesia for gynaecological surgery by inexperienced anaesthetists who failed to manage the airway and ventilation adequately. When trainee anaesthetists are relatively inexperienced their consultants must know the limits of their competence and when close supervision and help may be needed. One death was due to bupivacaine toxicity due to a drug administration error when a bag of dilute local anaesthetic was thought to be intravenous fluid. In a further 31 cases poor perioperative management may have contributed to death. Obesity was again a relevant factor. Other cases could be categorized into poor recognition of women being sick and poor clinical management of haemorrhage, sepsis and of pre-eclampsia. Early warning scores of vital signs may help identify the mother who is seriously ill. Learning points are highlighted in relation to the clinical management of these obstetric complications.
G M Cooper; J H McClure
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  100     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-11     Completed Date:  2008-01-14     Revised Date:  2008-04-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  17-22     Citation Subset:  IM    
University of Birmingham and Birmingham Women's Hospital, Birmingham, UK.
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MeSH Terms
Anesthesia, Obstetrical / methods,  mortality*,  standards
Great Britain / epidemiology
Maternal Mortality*
Medical Errors
Obesity / complications
Postoperative Complications / mortality
Postpartum Hemorrhage / mortality,  therapy
Pregnancy Complications
Comment In:
Br J Anaesth. 2008 Apr;100(4):561   [PMID:  18344576 ]

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