Systemic Analgesia: Parenteral and Inhalational Agents
Abstract Systemic drugs have been used to decrease the pain of childbirth since 1847, when James Young Simpson used diethyl ether to anesthetize a parturient with a deformed pelvis. Since…
Spinal, Epidural, and Caudal Anesthesia: Anatomy, Physiology, and Technique
Abstract The art and science of neuraxial anesthesia requires a thorough appreciation of neuroanatomy and the physiologic effects imposed by medications commonly administered via the spinal and/or epidural route. Successful…
Local Anesthetics and Opioids
Abstract Local anesthetics and opioids are often used for pain relief in obstetric practice. Local anesthetics may be used for infiltration anesthesia, peripheral (pudendal) nerve block, or neuraxial block, whereas…
In VitroFertilization and Other Assisted Reproductive Technology
Abstract Despite the application of ART procedures to a greater diversity of infertility causes, the probability of a live birth after a cycle of hormonal stimulation has increased from 6%…
Problems of Early Pregnancy
Abstract Obstetric disease of early pregnancy may result in significant maternal morbidity and even mortality. Safe care of patients with obstetric disease involves a thorough understanding of the physiologic changes…
Fetal and Neonatal Neurologic Injury
Abstract The detection and diagnosis of fetal and neonatal brain injury have been advanced by improvements in functional imaging and the identification of potential biochemical markers. Evidence indicates that inflammatory…
Anesthesia for Fetal Surgery and Other Intrauterine Procedures
Abstract Advances in prenatal diagnosis, imaging, and surgical equipment have all contributed to the development of fetal surgery. Some fetal abnormalities are amenable to intrauterine fetal surgery, but the majority…
Intrapartum Fetal Assessment and Therapy
Abstract Accurate fetal assessment in labor remains challenging despite the application of new technologies. An elevated cesarean delivery rate and persistent cases of fetal/neonatal neurologic injury indicate the need to…
Patient Safety and Team Training
Abstract In this chapter, methods of improved teamwork communication and collaboration, as well as issues related to medical errors, are reviewed, and solutions to enhance maternal safety are highlighted. Although…
Antepartum Fetal Assessment and Therapy
Abstract Obstetric care providers have two patients, the mother and the fetus. Although assessment of maternal health is relatively straightforward, assessment of fetal well-being is far more challenging. Several tests…
