Obstetric Anesthesiology as the Third Pillar of Perinatology

Abstract

Perinatology emerged in the second half of the 20th century when the examination, care, and treatment of the fetus as a patient became possible before and during birth with various biochemical and biophysical methods. The life functions of preterm newborn infants could be maintained with intensive care therapy. Nowadays, the health and the life of pregnant and puerperal women as well as their fetuses/neonates can dominantly be supported by professionals in obstetrics, neonatology, and anesthesiology. Perinatology combines collaborative efforts from obstetrics, neonatology, and anesthesiology, along with intensive therapy for caring about the life and health of the mother and the fetal/neonatal patients. In this volume, the third pillar of the triangle of perinatal care is emphasized. Participation of obstetrical anesthesiologists in the process of indication, mode of anesthesia, and timing of operative delivery is essential. Preeclampsia/eclampsia/hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, and serious peripartum bleeding are the most common maternal and fetal life-threatening conditions, which require a high level of adult intensive care. The objective of this review is to prove the role of anesthesiology and intensive therapy as the third pillar of perinatal medicine in the management of great obstetrical syndromes.