Obstetric Anesthesia for Parturients with Respiratory Diseases

Aug 24, 2016 by in ANESTHESIA Comments Off on Obstetric Anesthesia for Parturients with Respiratory Diseases

         II.Asthma A. Introduction 1.   Asthma presentation and symptoms. Asthma causes episodic partially reversible airway obstruction resulting from bronchoconstriction, inflammation, hyperresponsiveness, and mucous plugging. Symptoms include wheezing, chest tightness, difficulty breathing, and…

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Cardiac Disease in the Obstetric Patient

Aug 24, 2016 by in ANESTHESIA Comments Off on Cardiac Disease in the Obstetric Patient

3.   Left heart obstruction (mitral valve area <2 cm2, aortic valve area <1.5 cm2, or peak left ventricular outflow tract gradient >30 mm Hg by echocardiography) 4.   Reduced left ventricular function (ejection…

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Neurologic Deficits Following Labor and Delivery

Aug 24, 2016 by in ANESTHESIA Comments Off on Neurologic Deficits Following Labor and Delivery

2.   Despite the very low incidence of neurologic injury, it represents a significant contributor to malpractice litigation. Davies et al.11 performed an obstetric anesthesia closed claims analysis of 426 claims from…

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Newborn Resuscitation

Aug 24, 2016 by in ANESTHESIA Comments Off on 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…

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Thrombophilias/Coagulopathies

Aug 24, 2016 by in ANESTHESIA Comments Off on Thrombophilias/Coagulopathies

Vascular spasm, mediated by vasoconstrictor substances released from platelets, reduces blood flow and occurs in the first stages of hemostasis. Damaged endothelium attracts platelets, which adhere to it, forming a…

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Fetal Assessment and Monitoring

Aug 24, 2016 by in ANESTHESIA Comments Off on 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…

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Renal and Hepatic Disease in the Pregnant Patient

Aug 24, 2016 by in ANESTHESIA Comments Off on 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…

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Difficult Airway Management in the Pregnant Patient

Aug 24, 2016 by in ANESTHESIA Comments Off on 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…

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