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Anaesthesia Safety Second Trimester — FRCA Final MCQ

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EasyObstetric AnaesthesiaAnaesthesia Safety Second TrimesterFRCA Final

A 35-year-old woman (ASA II) at 26 weeks gestation requires an emergency appendicectomy. She is anxious about the effect of anaesthesia on her baby. According to current evidence, which statement about anaesthesia in the second trimester of pregnancy is most accurate?

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Correct answer: C — All anaesthetic agents are teratogenic in the second trimester

The second trimester (13-27 weeks) is considered the safest time for non-obstetric surgery in pregnancy. No currently used anaesthetic agent has been proven teratogenic in humans at clinical doses. The main risks to the fetus are from: the surgical condition (peritonitis, sepsis), maternal hypotension, maternal hypoxia, and preterm labour (incidence 5-8% after non-obstetric surgery). Both GA and regional anaesthesia are safe. Continuous fetal monitoring from viability (24 weeks) is recommended. Tocolytics should be available. Left lateral tilt from 20 weeks is mandatory.

Reference: RCOA – 2023 – Anaesthesia in pregnancy; NICE – 2017 – Anaesthesia during pregnancy