[Maternal risk from general anaesthesia and regional anaesthesia (author's transl)].

It may be presumed that in 1979, 150 maternal deaths will occur in obstetrics (0.27 per 1000) in the Fed. Rep. of Germany, 40% of which will be due to caesarean sections. From 30% to 50% of this maternal death rate, must be related in one or another aspect to general or local anaesthesia. The maternal morbidity rate may be even higher, because 500,000 parturients a year are treated with caesarean sections, and up to 50% of all parturients with epidural anaesthesia. General anesthesia as well as regional anaesthesia can be maternal risk factors, due to hypoxia or hypercarbia, due to hyper- or hypotension, arrhythmias, inferior vena cava occlusion etc. By endotracheal intubation adequate ventilation can be guaranteed and mothers may be protected from aspiration; the same procedure can also be responsible for hypoxic death or aspiration. Water-electrolyte balance and metabolism carry maternal risks, when inadequate substitution is performed or when fluid and electrolytes are administered in excess, together with modern obstetric drugs. Anaesthesists as well as obstetricians should be aware of the increased maternal risk from general or local anaesthesia. The maternal risk should be minimized. This can either be achieved if experienced anaesthesists only are responsible for obstetric anaesthesia (general as well as epidural, spinal etc.) if anaesthesia (general as well as local) is not considered as a comfortable service only but a strictly indicated medical procedure, and if new methods are developed to overcome the particular maternal risk in some regard.