Fetal Changes Associated with Maternal Anesthesia: A Narrative Review

• DOI: https://doi.org/10.22533/at.ed.15941012402123

• Palavras-chave: Maternal anesthesia; Fetal safety; Regional anesthesia; Neurodevelopment; Obstetric care

• Keywords: Maternal anesthesia; Fetal safety; Regional anesthesia; Neurodevelopment; Obstetric care

• Abstract: INTRODUCTION Maternal anesthesia is a cornerstone of obstetric care, requiring careful consideration of its effects on both mother and fetus. This review examines the physiological changes of pregnancy that influence anesthetic pharmacokinetics, compares the safety profiles of regional and general anesthesia, and evaluates their impact on fetal outcomes. Regional anesthesia, particularly in cesarean deliveries, demonstrates a superior safety profile due to reduced systemic drug exposure and improved neonatal Apgar scores. General anesthesia, though essential in emergencies, presents challenges such as potential fetal respiratory depression and altered hemodynamics.  OBJETIVE To evaluate the impact of maternal anesthesia, including regional and general techniques, on fetal outcomes, focusing on safety, pharmacological effects, and clinical guidelines.  METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Maternal Anesthesia” AND “Fetal Outcomes” OR “Regional Anesthesia” OR “General Anesthesia Risks” OR “Obstetric Anesthetic Management” in the last  years. RESULTS AND DISCUSSION Regional techniques are associated with fewer complications and better neonatal outcomes. General anesthesia poses higher risks of fetal oxygenation and acid-base imbalances, especially in high-risk pregnancies. Pharmacological advancements, including short-acting agents, and monitoring innovations have enhanced maternal and fetal safety. However, the long-term neurodevelopmental effects of fetal anesthetic exposure remain uncertain, necessitating further research. Ethical considerations and patient-centered approaches are critical in ensuring comprehensive care during pregnancy.  CONCLUSION maternal anesthesia must balance maternal comfort with fetal safety, guided by evidence-based practices and tailored to individual clinical scenarios. While regional anesthesia is preferred for most obstetric procedures, general anesthesia requires meticulous management to minimize risks. Advances in technology and multidisciplinary collaboration are essential for optimizing outcomes, ensuring safety, and addressing research gaps in this field.