Labor analgesia for the parturient with respiratory disease: what does an obstetrician need to know?
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- Kuczkowski, K.M. Arch Gynecol Obstet (2005) 272: 160. doi:10.1007/s00404-004-0703-1
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Significant alterations occur in the pulmonary system during pregnancy, which primarily serve to meet the increased oxygen consumption by the growing fetus. When pregnancy is complicated by a respiratory tract disorder such as asthma, cystic fibrosis or tobacco-related respiratory complications the peripartum management (both obstetric and anesthetic) may become challenging.
Regional anesthesia remains the technique of choice for these parturients because airway manipulation and endotracheal intubation are avoided.
When providing labor analgesia to parturients with asthma, cystic fibrosis, and tobacco-related respiratory disorders every effort should be made to reduce the likelihood of high (thoracic) levels of analgesia and/or anesthesia and subsequent airway compromise.