Peripartum psychiatric disorders are common, and it is likely that an obstetric anaesthesiologist will be involved with the care of a patient with one of these disorders. The most common psychiatric disorders encountered in the peripartum period include depression, anxiety, bipolar disorder, post-traumatic stress disorder, and schizophrenia. These conditions are commonly underdiagnosed and undertreated but may have grave maternal and neonatal consequences. Additionally, postpartum psychiatric disorders, specifically anxiety and depression, are common complications of childbirth. The rising prevalence of these disorders in the peripartum period necessitates an understanding of the epidemiology, management, and treatment options. Evidence on how psychiatric disorders and their treatment can affect the mother, baby, and the delivery of anesthesia care is presented. This chapter reviews important anesthesia considerations for pregnant patients with psychiatric disorders and interactions that may occur between anesthesia and the medical management of these disorders. Additionally, interventions and prevention techniques to improve patient care and manage postpartum psychiatric sequelae are explored.

Symptoms relating to the musculoskeletal system are among the most common complaints registered by pregnant women. The maternal axial skeleton is subjected to considerable gestational changes and stresses; congenital and acquired skeletal anomalies may impact both the process and outcome of gestation and labor. The most common anomaly is scoliosis, arising either in the idiopathic form or from an underlying neuromuscular disorder. Other less common conditions include symptomatic lumbar disc herniation, ankylosing spondylitis, spondylolysis, and spondylolisthesis. Most scoliotic patients will experience pregnancy, labor, and delivery with a similar incidence of complications as the general population. However, within the population of scoliotic parturients, there is a subpopulation at higher risk for morbidity and mortality. These patients include those with scoliosis resulting from neuromuscular disorders and severe restrictive pulmonary disease complicated by pulmonary hypertension. A multidisciplinary team approach best serves these patients. The obstetric and anesthetic management of patients with less common and less extreme vertebral syndromes is guided by individual case characteristics.