A 29-year-old woman is in labour and is 8 cm dilated. This is her second pregnancy. She has been in labour for the last 16 hours. Labour has not progressed for the last 8 hours despite augmentation with syntocinon.

The decision is made to proceed to Caesarean section. During the anaesthetic review, the patient states that she wants to be asleep for the procedure and does not want a regional anaesthetic.

Questions

  1. What is the grade of Caesarean section? (Click here for the answer.)
  2. What would be the optimum anaesthetic choice? (Click here for the answer.)

Answer:

This is a grade 3 Caesarean section.

Answer:

If the patient is able to understand and weigh the advantages and disadvantages of the different anaesthetic options, and chooses a general anaesthetic despite a clear explanation and reassurance on any specific points she has concerns about, then her choice must be respected. She should be given her choice of anaesthesia.

The only exception would be the existence of a clear contraindication or increased risk with general anaesthesia.

If there is disagreement or doubt, senior help should be sought.