International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 1998
Operative obstetric mortality at Harare Central Hospital 1992-1994: an anaesthetic view.
A prospective review of anaesthetic-associated deaths (AAD) was undertaken at the maternity unit of Harare Central Hospital, Zimbabwe, for the triennium 1992-1994. AAD was defined as death within 24 h of anaesthesia or failure to regain consciousness. Three groups of avoidable factors (obstetric, anaesthetic and administrative) were considered, and a scoring system used to allocate one avoidability point for each death with avoidable factors. ⋯ The problems are discussed and also viewed in the context of overall maternal mortality (outcome period 42 days). The mortality data are compared with those from the UK and some hospitals in South Africa. It is concluded that improvements in resources, education, guidelines and monitoring are necessary if the mortality rate is to be reduced.
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We report the anaesthetic management of a primiparous patient presenting in late pregnancy with rapidly progressive bitemporal hemianopia due to a pituitary mass caused by autoimmune hypophysitis. Caesarean section was complicated by post-partum haemorrhage. Anaesthesia is discussed together with a review of the literature on lymphocytic hypophysitis.