LAUSR

Correspondence to Emilia Guasch, PhD, Department of Anesthesia and The present issue has been scheduled before, developed during, and published, probably after the COVID 19 outbreak. Neither of the topics we have showed here speak even one word on it, but COVID 19 is beating very hard our life and our health system. I’ve been thinking on this editorial, as an opinion text and I’ll try to divide it in three parts: obstetric anesthesia before, during, and after the outbreak. Before the outbreak, many of us, were really concerned in and dedicated to reach the highest standards of practice in this particular field of anesthesia. We used to deal with healthy patients, sometimes not so healthy, and we tried to offer them as many choices as possible to elect what they really wanted for a better experience of birth. In terms of sick mothers, we were mainly focused on decreasing maternal morbidity, related to obesity, aging patients, cardiovascular diseases and of course postpartum hemorrhage (PPH), eclampsia, and other conditions that were threatening our modern society. And suddenly, a new threaten came to our delivery suites. I mean mainly COVID 19, but it is not only the virus itself. Because of the epidemic, our delivery suites became not so important. We had to deal with infected mothers, and at the same time, we had to develop protocols when nothing or almost nothing was known about the new disease (self protection, severity in pregnancy, neonatal transmission). Meanwhile, very sick patients were admitted to our ICU, and we had to build new ICU in places we had never thought about. Many human resources have been transferred to these units, including nurses, residents, etc. Everybody knows that obstetric activity cannot be stopped or delayed as it has been scheduled surgery. Our patients cannot wait, for several reasons, and we have the duty to treat these patients with good standards of care. In our hospital, we are maintaining the epidural analgesia program and to increase as much as possible our epidural rate, trying to avoid a general anesthesia in case of cesarean delivery. The usual circuit of the parturients has changed, and sometimes, we