• J Hamza.
• Département d'Anesthésie-Réanimation, Hôpital St-Vincent-de-Paul, Paris.
• Cah Anesthesiol. 1994 Jan 1;42(1):47-59.

AbstractAnaesthesia for fetal distress is usually indicated for emergency caesarean section. General anaesthesia, which is the classical technique in these cases, remains the leading cause of anaesthesia-related maternal mortality. Difficult intubation and Mendelson's syndrome are mostly responsible for these fatalities. Nevertheless there are several answers to this problem. A better evaluation of the patient's problems based upon a preanaesthetic outpatient visit during the last term of pregnancy allows a more rational approach to meet the patient's requirements should an emergency caesarean section occur. For example, a "prophylactic" epidural instituted soon after the beginning of labor may be lifesaving in a patient with obvious signs of difficult intubation. A clear definition of safe standards of equipment and practices both to prevent Mendelson's syndrome or to cope with a failed intubation through a "failed intubation drill" is of paramount importance. Finally, a comprehensive communication between anesthetic and obstetrical teams is one of the most useful ways to allow a safer approach of the management of obstetric emergencies such as caesarean section for fetal distress.

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