Authors: Heather C. Nixon, M.D.; Edward (Ted) Yaghmour, M.D.
ASA Monitor 03 2017, Vol.81, 8-9.
Heather C. Nixon, M.D., is Associate Professor of Anesthesiology, University of Illinois Hospital and Health Sciences System, Chicago.
Edward (Ted) Yaghmour, M.D., is Associate Professor and Director of Scheduling and Development, Northwestern University, The Feinberg School of Medicine, Department of Anesthesiology, Chicago.
The ASA Committee on Obstetric Anesthesia serves the members of our organization by promoting the best possible anesthesia care to pregnant women and their children throughout pregnancy, childbirth and the postpartum period.
The committee works collaboratively to create, edit and update ASA documents related to the anesthetic care of parturients. In addition, the committee works with other organizations such as the American College of Obstetricians and Gynecologists (ACOG) to create, review, revise or support documents. When the committee is asked to support a document, the process includes a review by the committee and then a review by the ASA Administrative Council and the Committee on Standards and Practice Parameters, as per ASA’s Administrative Procedures.1
This committee update is a summary of documents released in the last year as well as an overview of the committee activities and plans for the upcoming year.
• Optimal Goals for Anesthesia Care in Obstetrics – approved October 26, 2016, by the ASA House of Delegates
This document is currently available on both the ASA and the Society for Obstetric Anesthesia and Perinatology (SOAP) websites. The committee reviewed and revised this document, which makes recommendations regarding the availability of qualified personnel and equipment necessary to safely administer anesthesia in obstetric patients.
• Pregnancy Testing Prior to Anesthesia and Surgery –approved October 26, 2016, by the ASA House of Delegates
This document is currently listed on the ASA website under “Standards, Guidelines and Practice Parameters.” Two of our committee members, Drs. Grant Lynde and Wei Chao, worked collaboratively with the Committee on Quality Management and Departmental Administration (QMDA) and a workgroup led by Karen B. Domino, M.D., with members of the Committee on Ethics, Committee on Pediatric Anesthesia and Committee on Professional Liability.
The committee then reviewed and supported this document. It contains the following recommendations (taken directly from the document)2 :
1. Pregnancy testing may be offered to female patients of childbearing age and for whom the result would alter the patient’s management. Informed consent or assent of the risks, benefits, and alternatives related to preoperative pregnancy testing should be obtained.
2. In facilities where an informed consent process is adopted as policy, local policy development should also consider any associated documentation requirements.
3. Preanesthetic educational materials should be developed and given to patients to allow them to make an informed decision. This material should include information about false positives and negatives of pregnancy testing and that the scientific literature is inadequate to inform patients or physicians on whether anesthesia may cause unknown harmful effects during early pregnancy.
1. Nonobstetric Surgery During Pregnancy – ACOG Committee Opinion No. 474, February 2011, reaffirmed 2015.
This document update is scheduled to become a joint publication from both ASA and ACOG. It will be formally published in the April 2017 issue of Obstetrics & Gynecology.
• Obstetric Analgesia and Anesthesia – American College of Obstetricians and Gynecologists Practice Bulletin No. 176 (replacing Practice Bulletin 36).
The committee reviewed this document and made revisions.
Plans for Upcoming Year:
Continue to work closely with ACOG and SOAP to generate more joint and shared documents.
A thank you to:
• • Michael Lewis, M.D., Section Chair, and Beverly Philip, M.D., ASA Vice President for Scientific Affairs.
• • ASA, for its support of the subspecialty societies.
• • The members of the ASA staff offices for their support and responsiveness.
• • The committee members, both past and present, for their hard work and dedication to improving maternal care.
Administrative Procedures. American Society of Anesthesiologists website. http://www.asahq.org/member-center/governance-resources. Updated August 21, 2016. Last accessed January 13, 2017.
Standards, Guidelines & Practice Parameters. American Society of Anesthesiologist website. http://www.asahq.org/quality-and-practice-management/standards-and-guidelines. Last accessed January 13, 2017.