Anesthesiologists and certified registered nurse anesthetists (CRNAs) are frequently consulted to provide anesthesia pain relief care during labor and delivery.
Common types of obstetric anesthesia
For vaginal or natural deliveries, obstetric anesthesiologists and CRNAs often use an epidural for pain control. Epidural anesthesia is delivered by a catheter that’s inserted into the epidural space of the mother’s spine usually near the T10–L1 level. It’s usually a continuous infusion of anesthetic medication until after the baby is delivered.
For C-Sections, the go-to anesthesia method is frequently a spinal block, sometimes also called a saddle block or saddle anesthesia. For this fast-acting type of anesthesia, the medication is typically delivered by a single injection inside the dural sac that surrounds the spinal cord. The anesthetic effect lasts a few hours.
Prenatal anesthesiology consultation
Some patients have a higher anesthetic risk and should be referred to an anesthesiologist for consultation before going into labor and delivery. According to the American College of Obstetrics & Gynecology (ACOG) publications “Guidelines for Perinatal Care,” common indications for anesthesiology consultation include:
• Cardiac disease
• Hematologic abnormalities are risk factors
• Spinal, muscular, and neurologic disease
• Major liver or kidney disease
• History of or risk factors for anesthetic complications, including obstructive sleep apnea, anticipated difficult airway, malignant hyperthermia, or anesthetic allergies
• Obstetric complications that may affect anesthesia management, including placenta accreta
• Miscellaneous medical conditions, including sickle-cell anemia, myasthenia gravis, or body mass index of 50+
Obstetric anesthesia medical malpractice
A study of closed claims published in the journal Anesthesiology reported that potentially preventable anesthetic causes of newborn injuries include delays in anesthesia care and poor communication between the obstetrician (OB/GYN) and anesthesiologist.
Newborn baby death and brain damage top the list of injuries leading to claims against obstetric anesthesia providers. Most of these closed claims involved labor and delivery where there was a non-reassuring fetal heart tracing electronic fetal monitoring and an urgent or emergency C-section delivery. In nearly one-fourth of those cases, anesthesia care was felt to have played a potential role in newborn death or brain damage.
Common types of anesthesia negligence in the labor and delivery suite or operating room include:
• The anesthesiologist or CRNA was not in the hospital, leading to a delay
• Poor choice of anesthesia technique, including repeated attempts at regional anesthesia rather than general anesthesia, again leading to a delay in delivery
• Inadequate communication between the OB/GYN and anesthesia physician or provider about the urgency of C-section delivery
• Difficult intubation, causing hypoxic brain injury
• Hypotension (abnormally low blood pressure), causing hypoxic brain injury
If there’s a question about a maternal or newborn injury related to labor and delivery anesthesia care in Texas, then contact a top-rated, experienced Texas medical malpractice and birth injury attorney for a free strategy session about your potential case.
