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Review
. 2023 Apr;62(Suppl1):132-136.
doi: 10.20471/acc.2023.62.s1.17.

WHAT IS THE RELATIONSHIP BETWEEN A GYNECOLOGIST/OBSTETRICIAN AND THE AIRWAY?

Dubravko Habek  1   2 , Antonio Ivan Miletić  3 , Filip Medić  3
Affiliations
Review

WHAT IS THE RELATIONSHIP BETWEEN A GYNECOLOGIST/OBSTETRICIAN AND THE AIRWAY?

Dubravko Habek et al. Acta Clin Croat. 2023 Apr.

Abstract

Physiological changes in pregnancy as part of biohumoral and morphological changes (hyperemia, edema, hypersecretion) influence the possible problems in obstetric anesthesia. These changes by themselves, and particularly aggravated by acute or chronic gestational or non-gestational comorbidity, increase the risk of aspiration of gastric contents, failed intubation, esophageal intubation, inadequate ventilation, and respiratory failure. The types of premedication, anesthesia and techniques of anesthesia are evident from medical historiography. Almost obligatory promethazine and atropine was given intravenously either in the delivery room or on the operating table immediately before the induction of anesthesia in a dose of 0.5 mg in partuients of average body weight. Atropine has been a favorite premedicant for decades, given its pharmacological properties, especially its antisialogenic effect and absence of a depressant effect on the fetoplacental unit, but today it is rarely used. Nasal decongestants before surgery are not recommended but in cases of severe rhinitis, atropine, promethazine, or topical decongestants may be used.

Keywords: Airway; High-risk parturient; Obstetric anesthesiology; Obstetrics; Pregnancy.

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References

    1. Habek D, Šklebar I, Jurković I, Šakić K, Hrgović Z. Forensics in obstetric anesthesia. Period Biol. 2013;115:149–52.
    1. Habek D. Antologija bjelovarske anestezije. Bjelovar: »vor, 2010. (in Croatian)
    1. Habek D, Čartolovni A, Cerovac A. Medicolegal view of elective non-medical indicated caesarean section. Ginecol Perinatol. 2020;29(1-2):10–5.
    1. Habek D, Prka M, Čartolovni A, Cerovac A, Dokozić D. Caesarean section between doctrine to heresis. Medicoethical and deontological view of caesarology: an opinion. Clin Exp Obstet Gynecol. 2021;48:1–4. 10.31083/j.ceog.2021.01.2305 - DOI
    1. Habek D, Luetić A. Caesarean section: short- and long-term legal, deontological and health consequences. Pregled sodobne ginekologije in porodniπtva pred epidemijo Covida-19 leta 2020. Univerza u Mariboru, Medicinska fakulteta in Univerza u Ljubljani, Medicinska fakulteta, Maribor 2021; 676-80.

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