The administration of anesthesia to pregnant women and young children may negatively affect the neurological development of the child. Warnings issued by the U.S. Food and Drug Administration in 2016 strongly caution against the use of general anesthetic or sedatives during the third trimester and in children under the age of 3 years old, yet many obstetricians and gynecologists ignore this warning.
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Types of Anesthesia
General anesthetic is applied when it is necessary for the patient to "sleep" through the procedure. Essentially, the patient is placed in a medically induced coma that relieves anxiety, relaxes muscles, and eliminates the memory of the surgical procedure. It is typically reserved for deep, invasive procedures.
Regional anesthetics are applied for minor surgeries. They are used to numb entire regions such as the legs or arms.
Local anesthesia is applied for minor medical procedures such as filling a tooth, excising moles, or conducting skin biopsies. It is generally applied topically and the patient remains conscious throughout the procedure.
Effect of Anesthesia on Neurological Development
Anesthesia alters the function of cells within the body. It has significant effects on cell signaling, DNA synthesis, and cellular mitosis. When administered during pregnancy, these drugs can permanently injure the fetus and result in neurological damage.
These risks increase significantly when general anesthetic is used for procedures that last longer than 3 hours. Such prolonged exposure to anesthetic slows brain development and may permanently diminish the child's ability to learn and retain information after birth. Similarly, repeated exposure to anesthetic can have as much of an impact as a single significant exposure. For this reason, many physicians strongly recommend avoiding elective surgical procedures until after delivery.
Risk of Miscarriage, Preterm Delivery, and Birth Defects
The risk of miscarriage is greatest during the first few weeks of pregnancy, however, this risk continues throughout the gestation period. Significant exposure to anesthetic may cause the infant to suffer hypoxia or hypotension. If the anesthetic causes maternal hypercapnia, this can reduce blood flow throughout the uterus which can trigger fetal respiratory acidosis. Furthermore, some drugs including benodiazepine are known to cause cleft palates and cardiac abnormalities in unborn infants.
The mother's overall health during pregnancy has a significant impact on the development of the child. Anesthetic drugs which depress her immune system, affect her cardiac health, or cause an allergic reaction are likely to negatively affect the physical and neurological development of the unborn fetus.