Non-neuraxial Analgesic Techniques
b. Reflexology involves the act of applying pressure to the “reflex” points on the feet and palms. Reflexology has not only been used for pain relief but also for treating nausea,…
Anesthesia for Multiple Gestation and Breech Presentation
CLINICAL PEARLMultiple gestation delivery is high risk, associated with CD, preterm birth, and obstetric conditions such as preeclampsia. II.National Guidelines These U.S. guidelines present practice recommendations related to current evidence…
Postpartum Tubal Ligation
I. American Society of Anesthesiologists Practice Guidelines for Obstetric Anesthesia: recommendations for postpartum sterilization II. Postpartum anatomic and physiologic changes A. Cardiovascular changes B. Gastrointestinal changes III. Timing of postpartum…
Guidelines from National Organizations
1. Relevant American Society of Anesthesiologists standards a. Basic Standards for Preanesthesia Care Approved 1987, last amended 2010.11 In summary, these standards apply to all patients who receive anesthesia care. These standards…
Hypertensive Disorders of Pregnancy
2. Severe features of preeclampsia include BP ≥160/100 mm Hg on two occasions at least 4 hours apart; thrombocytopenia (platelet count <100,000 per μL); impaired liver function; severe persistent right upper…
Physiologic Changes of Pregnancy
b. Blood volume does not return to the prepregnancy level for greater than 6 weeks’ postpartum. 2. Cardiac output4 (Table 1.2) a. Cardiac output (CO) begins to increase at 10 weeks’ gestation, peaking…
Maternal Morbidity and Mortality
1. Cardiac disease is the leading cause of maternal death in both the United States and the United Kingdom.2,5 a. The combination of cardiovascular disease and cardiomyopathy caused 26% of maternal…
Anesthetic Considerations for Women Receiving Cesarean Delivery
III.Surgical considerations A. Technical aspects 1. CD involves the delivery of the fetus through an incision created in the maternal abdomen. For CD, either neuraxial or general anesthesia is used. Anesthetic…
Management of the Opioid Dependent Parturient
II.Obstetric management (see Fig. 31.3) A. Risks of opioid dependence in pregnancy 1. Opioid dependence in pregnancy is associated with poor maternal and fetal outcomes including miscarriage, preterm labor, preterm delivery,…
Endocrine Disorders
2. Oral hypoglycemic agents a. Women with pregestational type 2 DM who require oral agents for glucose control should ideally be changed to insulin before pregnancy. Although there is no evidence to…
