Obstetric Anesthesiology: Scope and History
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Obstetric anesthesia or obstetric anesthesiology, also known as ob-gyn anesthesia or ob-gyn anesthesiology is a sub-specialty of anesthesiology that provides peripartum (time directly preceding, during or following childbirth)pain relief (analgesia) for labor and anesthesia (suppress consciousness) for cesarean deliveries ('C-sections').
Other subspecialty options for anesthesiology include cardiac anesthesiology, pediatric anesthesiology, pain medicine, critical care, neuro anesthesia, regional anesthesia, transplant anesthesia and trauma anesthesia.
Obstetric anesthesiologists typically serve as consultants to ob-gyn physicians and provide pain management for both complicated and uncomplicated pregnancies. An obstetric anesthesiologist's practice may consist largely of managing pain during vaginal deliveries and administering anesthesia for cesarean sections; however, the scope is expanding to involve anesthesia for both maternal as well as fetal procedures.
Maternal-specific procedures include cerclage, external cephalic version (ECV), postpartum bilateral tubal ligation (BTL), and dilation and evacuation (D and E). Fetus-specific procedures include fetoscopic laser photocoagulation and ex-utero intrapartum treatment (EXIT).However, the majority of care given by anesthesiologists on most labor and delivery units is management of labor analgesia and anesthesia for cesarean section.
The administration of general anesthesia in operative procedures was publicly demonstrated by William Thomas Green Morton (1819–1868) in Boston, October 1846 as the first successful practice of its kind. This practice revealed the pain-annulling properties of ether inhalation during surgery. Pioneers of obstetric anesthesia extended these findings to cases of parturition or childbirth, notably including James Young Simpson of Scotland (1811-1870), John Snow of London (1813-1858) and Walter Channing of the United States of America (1786-1876).
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