Newborn Resuscitation
2. Fetal lung development takes place throughout pregnancy, and lung maturation continues well into the neonatal period. The pulmonary transition that occurs in the fetus is initiated before labor begins. Cortisol…
Renal and Hepatic Disease in the Pregnant Patient
C. Assessment of renal function during pregnancy 1. Renal function is commonly assessed by two techniques. The first measures serum levels of creatinine and BUN. However, these serum values will not…
Difficult Airway Management in the Pregnant Patient
B. Factors contributing to the difficult airway. Difficult mask ventilation, difficult laryngoscopy, and difficult intubation are factors that contribute to a difficult airway. 1. Difficult mask ventilation and difficult laryngoscopy occurs…
Fetal Assessment and Monitoring
6. Individualized risk assessment determines choice of modality. The risk of iatrogenic premature delivery, prompted by false-positive testing results, must be considered. B. Screening ultrasound survey 1. A screening ultrasound exam is commonly…
Neurologic and Neuromuscular Disease
(1) The Cobb angle measures the degree of spinal curvature (see Fig. 26.2). Minor curves (10 to 20 degrees) occur in approximately 2% of adolescents in the United States. These are…
Choice of Neuraxial Analgesia and Local Anesthetics
B. First stage of labor. Pain during the first stage of labor is essentially visceral in nature and occurs due to a combination of both uterine contractions and endocervical dilation. Although…
Obstetric Emergencies
a. Decreased maternal O2 tension is an uncommon cause of intrapartum fetal asphyxia. Clinical situations that may result in decreased maternal O2 tension and fetal hypoxia include anemia, pulmonary edema, smoking,…
Obesity and Pregnancy
B. Maternal comorbidities. Obesity is implicated as a direct cause in the development of disease in many organ systems (see Table 29.1). As maternal body mass index (BMI) increases, the…
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…
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…
