Passagem transplacentária e efeitos embriofetais de drogas usadas em anestesia

Abstract

Background and Objectives - Anesthesia for pregnant patients has several peculiarities that need to be adequately analyzed. Besides fetus exposure and possible toxic effects of anesthetic agents, gestational age, drug properties and doses should be considered. The lack of adequate information about the risk of using drugs during gestation turns it difficult for anesthesiologists to make a safe choice when facing the need to anesthetize a pregnant patient, both for non-obstetric or for obstetric surgery. In the former case, it is important to avoid premature labor (or abortion) and permanent fetus abnormalities; in the latter, there should be neither interference on uterine contractility nor significant fetus depression. This review aimed at updating information on placental transfer of anesthetic drugs and maternal-fetal effects of anesthetic drugs. Contents - The mechanisms of placental transfer of drugs and the basic principles of embryo-fetotoxicity are reviewed and important aspects of embryo-fetal effects of anesthetic drugs are analyzed. FDA's classification of drugs most frequently used in anesthesia is presented, according to their teratogenic risk. Conclusions - There are still many issues involving the choice of anesthetic drugs to be used in pregnant patients, but today there are new drugs and information allowing anesthesiologists to grant greater security to both mother and fetus.