Anesthetic management of urgent cesarean section

Abstract

The validity of the 30-minute cesarean section (CS) rule has been questioned. A new classification of the urgency of CS was introduced by the NICE in the United Kingdom and has received considerable attention in recent years. In the guideline, categories 1 and 2 are defined as “immediate threat to the life of the woman or fetus” and “maternal or fetal compromise which is not immediately life-threatening”, respectively, and the recommendation is to “perform category 1 and 2 CS as quickly as possible after making the decision, particularly for category 1” and to “perform category 2 CS in most situations within 75 minutes of making the decision”. In consideration of these suggestions, the anesthetic method should be chosen from among general anesthesia following rapid sequence induction, rapid sequence spinal anesthesia, and epidural anesthesia converted from epidural labor analgesia.