Ranasinghe J Sudharma, Birnbach David
Professor, Department of Anesthesiology, Obstetric and Gynaecology and Public Health, University of Miami Miller School of Medicine.
Indian J Anaesth. 2009 Oct;53(5):608-17.
The Centers for Disease Control and Prevention (CDC) reported in 2003 that although the maternal mortality rate has decreased by 99% since 1900, there has been no further decrease in the last two decades1. A more recent report indicates a rate of 11.8 per 100,000 live births2, although anaesthesia-related maternal mortality and morbidity has considerably decreased over the last few decades. Despite the growing complexity of problems and increasing challenges such as pre-existing maternal disease, obesity, and the increasing age of pregnant mothers, anaesthesia related maternal mortality is extremely rare in the developed world. The current safety has been achieved through changes in training, service, technical advances and multidisciplinary approach to care. The rates of general anaesthesia for cesarean delivery have decreased and neuraxial anaesthetics have become the most commonly used techniques. Neuraxial techniques are largely safe and effective, but potential complications, though rare, can be severe.
美国疾病控制与预防中心(CDC)在2003年报告称,尽管自1900年以来孕产妇死亡率已下降了99%,但在过去二十年中并未进一步下降。1 最近的一份报告显示,每10万例活产中有11.8例死亡,2 尽管在过去几十年中与麻醉相关的孕产妇死亡率和发病率已大幅下降。尽管问题日益复杂,挑战不断增加,如孕产妇既往疾病、肥胖以及孕妇年龄增大等,但在发达国家,与麻醉相关的孕产妇死亡极为罕见。目前的安全性是通过培训、服务、技术进步以及多学科护理方法的改变而实现的。剖宫产全身麻醉的发生率已下降,神经轴索麻醉已成为最常用的技术。神经轴索技术在很大程度上是安全有效的,但潜在并发症虽然罕见,却可能很严重。