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…
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…
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…
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…
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…
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,…
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…
B. Local anesthetics with an ester bond linking the aromatic ring to the hydrocarbon chain are classified as amino-ester local anesthetics. These include procaine, 2-chloroprocaine, tetracaine, and cocaine (see Table…
A. Anatomic and physiologic changes. Maternal anatomic and physiologic changes occur during pregnancy to ensure enough blood flow is delivered to the uterus. Uterine blood flow occurs through two routes. 1. …
g. The demand-only IV PCA incorporates several safety features to minimize the possibility of a patient receiving unsafe doses of IV opioid. First, the PCA pump is programmed to limit the…
