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…
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…
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,…
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…
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…
