Petr Beneš, MD Department of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Czech Republic
Caesarean section is a non-physiologic method of a giving birth. It is caused by failure of natural obstetrical mother’s mechanisms or adaptive mechanisms of a foetus. Frequency of the Caesarean sections has a steep growth, which is going to continue. In anaesthesiology it is unique, high-specific situation, which needs for successful mastering correct and standardized anaesthesiological procedure, which will respect by chosen technique and pharmacological intervention physiological specificity of gravidity, anatomical and anamnestic specificity of patient and pathophysiological problems of patient or foetus and their common time urgency to end the delivery. The growing incidence of pathological gravidity (very often polymorbid patients with Caesarean section in anamnesis) increase probability of major peripartum and perioperative complications, which needs emergent solution and so there are made demands of erudition of anaesthesiological team. Any mistake in chosen anaesthesiological strategy can cause irreversible health effects of mother and child, associated with merciless forensic implications for concerned. Presented anaesthesiological algorithms of Sectio Caesarea present such needed practical guidance for effective, rational and forensic acceptable managing of specific clinical situation in everyday clinical practice.Proceeding standardly according to the algorithm does not mean to lose ourselves, but rather to buy time and space to become gradually, at this often critical situation, master of the situation. Improvise standardly - not only in this indication is unacceptable-medically, ethically and forensic.
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