RT Book, Section
A1 Stein, Deborah J.
A1 Bate, Thomas E.
A2 Santos, Alan C.
A2 Epstein, Jonathan N.
A2 Chaudhuri, Kallol
SR Print(0)
ID 1108523047
T1 Assessment of the Newborn and Neonatal Resuscitation
T2 Obstetric Anesthesia
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071786133
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1108523047
RD 2024/04/24
AB Anesthesiologists  are  often  involved  in  various  aspects  of  care  on  a  labor  and  delivery  unit.  However,  the  anesthesiologist’s  primary  responsibility  is  to  provide  care  to  the  mother,  particularly  during  an  anesthetic  for  cesarean  or  complicated  vaginal  delivery.  Thus,  on  a  labor  and  delivery  unit,  at  least  one  person  other  than  the  members  of  surgical  team  should  be  qualified  to  provide  neonatal  resuscitation  and  be  immediately  available  to  assume  responsibility  for  resuscitation  of  the  depressed  newborn.1  Because  the  primary  responsibility  of  the  obstetrician  and  anesthesiologist  is  care  of  the  mother,  these  individuals  may  not  be  able  to  shift  care  from  the  mother  to  the  newborn.  For  the  anesthesiologist,  this  may  even  be  the  case  when  the  patient  has  a  neuraxial  anesthetic  that  is  functioning  adequately.1  However,  the  anesthesiologist  should  offer  assistance  in  situations  including  management  of  a  difficult  neonatal  airway  or  during  the  absence  of  a  designated  qualified  individual  for  resuscitation.  The  benefit  to  the  child  must  be  weighed  against  the  risk  to  the  mother  in  these  special  circumstances.2  In  the  majority  of  situations,  after  assisted  vaginal  delivery  or  cesarean  section,  the  mother  is  stable;  therefore,  if  there  is  a  need  for  neonatal  resuscitation,  the  anesthesiologist  should  be  available  to  help.  In  certain  institutions,  there  may  be  an  anesthesia  care  team  caring  for  the  mother  (eg,  an  attending  and  a  resident  or  fellow,  or  a  nurse  anesthetist).  If  the  mother  is  stable,  one  member  of  this  team  may  be  free  to  help  care  for  the  neonate.  It  is  important  to  keep  in  mind  that  soon  after  delivery  the  mother  is  undergoing  tremendous  physiologic  changes  and  maternal  status  may  change  quickly.  It  still  remains  a  judgment  call  for  the  anesthesiologist  in  charge  to  determine  where  his  or  her  priorities  lie—caring  for  either  the  mother  or  the  newborn  or  caring  for  both.