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Observational analysis shows optimal maternal PaCO2 can improve oxygen delivery in pregnant models during anesthesia, suggesting better fetal outcomes.
( Anesth Analg . 2025;140(1):175-184. doi: 10.1213/ANE.0000000000006872) General anesthesia is occasionally necessary during pregnancy, whether for maternal trauma, obstetric procedures such as cerclage, cesarean delivery, or even fetal surgery. Current practice guidelines recommend maintaining the maternal arterial partial pressure of carbon dioxide (PaCO 2 ) at approximately 30 mm Hg. This target is derived from the typical physiologic levels observed in awake pregnant women rather than from experimental evidence confirming its benefit for fetal well-being under anesthesia. Because maternal ventilation can influence uterine blood flow, oxygen delivery, and fetal gas exchange, determining the most appropriate maternal PaCO 2 during surgery is essential.
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Valenzuela et al. (2025) studied this question.
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