Indian journal of anaesthesia
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Obstetric emergencies are a challenge both for the obstetrician and the anaesthesiologist. The incidence of caesarean sections as per the National Family Health Survey published in 2015-16 was 17.2%. In 7.6% of cases, the decision to conduct a caesarean section was taken after the onset of labour pains. ⋯ In category 2 and 3 caesarean sections, spinal anaesthesia still remains the technique of choice. Failed intubation, failed neuraxial block, extensive neuraxial block, awareness under anaesthesia, thromboembolism, amniotic fluid embolism, haemorrhage and maternal collapse are some of the complications. Haemorrhage is said to be the leading cause of mortality worldwide.
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An increasing number of caesarean sections are being performed for both elective as well as emergency cases. Category 4 caesarean section refers to a planned elective surgery after 39 weeks of gestation at a time suitable to the mother and the maternity team. ⋯ The management should include adequate postoperative pain relief, early ambulation, and thromboprophylaxis to ensure early recovery. This review will discuss the anaesthetic management including regional anaesthesia, general anaesthesia, and postoperative analgesia for elective, low-risk (Category 4) caesarean section.