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Pharmacology, Physiology, and Practice in Obstetric Anesthesia

Specificaties
Paperback, blz. | Engels
Elsevier Science | e druk, 2025
ISBN13: 9780443217074
Rubricering
Elsevier Science e druk, 2025 9780443217074
€ 187,00
Levertijd ongeveer 8 werkdagen

Samenvatting

Pharmacology, Physiology, and Practice in Obstetric Anesthesia provides all the essentials of obstetric anesthesia in a straightforward, user-friendly format that avoids encyclopedic language and lengthy discussions, and is inclusive of other healthcare specialties and subspecialties including obstetrics, neonatal care, and more. Coverage spans the essentials of obstetrics as well as overlooked issues including obstetric pharmacology and physiology safe practice strategies, clinical concepts for vaginal delivery and C-section, high-risk pregnancy states and management of the complicated parturient, complications and medicolegal, fetus and newborn considerations, and guidelines, standards and statements related to obstetric anesthesia.

Pharmacology, Physiology, and Practice in Obstetric Anesthesia is the perfect reference for an interdisciplinary group of health professionals, policymakers, and researchers working and training in the field of obstetric anesthesiology

Specificaties

ISBN13:9780443217074
Taal:Engels
Bindwijze:Paperback

Inhoudsopgave

Contributors <br>About the editors <br>Preface <br><br>1. Physiological maternal adaptive changes during pregnancy, e.g., alterations of endometrium and decidua, menstruation, placenta, fetal membranes, placental hormones, morphological and functional fetal development<br>Amber N. Edinoff, Brooke Williams, Layne Landry, Elyse M. Cornett and Alan David Kaye<br><br>1. Introduction <br>2. Estrogen and progesterone in pregnancy <br>2.1 Progesterone <br>2.2 Estrogen <br>2.3 Decidualization <br>3. Physical changes in pregnancy <br>3.1 Cardiovascular system <br>3.2 GI system <br>3.3 Respiratory system <br>3.4 Skin <br>3.5 Sensory <br>3.6 Hematology <br>4. Pharmacologic changes in pregnancy <br>4.1 Absorption <br>4.2 Distribution <br>4.3 Metabolism <br>4.4 Elimination <br>5. Issues arising from the physiologic changes of pregnancy <br>5.1 Hypertensive disorders of pregnancy <br>5.2 Peripartum cardiomyopathy <br>5.3 Pulmonary changes in pregnancy <br>5.4 Postpartum depression <br>6. Conclusion<br>References<br><br>2. Anatomy of the reproductive tract: The placenta, uteroplacental circulation, anatomy, transfer of drugs, and respiratory gas exchange<br>Jessica Galey, Amy Zheng and Shobana Bharadwaj<br><br>1. Anatomy of the female reproductive tract<br>1.1 Organs<br>1.2 Innervation <br>1.3 Blood flow<br>1.4 Uterine blood flow changes during pregnancy <br>2. Anatomy of the placenta<br>2.1 Embryology<br>2.2 Macroscopic anatomy<br>2.3 Maternal vasculature<br>2.4 Fetoplacental vasculature<br>3. Placental physiology<br>3.1 Oxygen transfer<br>3.2 Carbon dioxide transfer <br>3.3 Acid base<br>3.4 Placental drug transfer<br>3.5 Common drugs used during pregnancy<br>3.6 Anesthetic drugs and placental transfer<br>4. Conclusion<br><br>3. Uterine blood flow and the effects of obstetric anesthesia<br>John Pallan, Amy Zheng, Jessica Galey and Shobana Bharadwaj<br><br>1. Introduction<br>2. Anatomy<br>3. Uteroplacental blood flow<br>4. Response to vasoactive agents<br>5. Mechanisms of changes<br>6. Determinants of uterine blood flow<br>7. Measuring uterine blood flow<br>8. Regional anesthesia and uterine blood flow<br>9. Doppler ultrasonography and uterine blood flow<br>10. General anesthesia and uterine blood flow<br>11. Effects of obstetric drugs<br>12. Conclusion<br><br>4. Perinatal pharmacology<br>Rucha Kelkar, Alina Smoleva, Therese Larson, Sahar Shekoohi and Alan David Kaye<br><br>1. Definition, background<br>2. Maternal factors<br>3. Placental factors<br>4. Basic fetal pathophysiology and risk factors<br>5. Fetal drug uptake, distribution, metabolism, and excretion<br>6. Related issues, historical trends<br>References<br><br>5. Parturient anesthesia assessment and evaluation<br>Hrayr Ghazaryan, Artush Grigoryan and Lincoln Frederick Arbogast<br><br>1. Introduction<br>2. History of anesthesia in obstetrics<br>3. Physiological changes in pregnancy<br>3.1 Cardiovascular<br>3.2 Respiratory<br>3.3 Gastrointestinal<br>3.4 Urinary<br>3.5 Endocrine<br>3.6 Hematologic <br>3.7 Coagulation<br>4. Preanesthesia evaluation of parturients<br>4.1 Past surgical history and anesthetic history<br>4.2 Past obstetric history<br>4.3 Past medical history<br>4.4 Physical examination<br>5. Evaluation of parturient with systemic disease<br>5.1 Cardiovascular diseases <br>5.2 Respiratory diseases <br>5.3 Anemias <br>5.4 Coagulation disorders <br>6. Endocrine diseases <br>6.1 Diabetes mellitus <br>6.2 Hyperthyroidism <br>6.3 Musculoskeletal disorders <br>6.4 Renal diseases<br>6.5 Liver diseases<br>7. Conclusion <br>References<br><br>6. How to create and maintain a safe and an efficient obstetric anesthesia practice<br>Anjum Anwar, Huma Wali and Hina Shamim<br><br>1. Introduction<br>2. Maternal care framework in the United States<br>3. Preanesthesia evaluation for obstetric patients <br>3.1 Background <br>4. Current state of affairs and challenges <br>4.1 Recommendations <br>5. Telemedicine <br>6. Patient education <br>7. Intrapartum care for parturient <br>7.1 Introduction <br>8. Challenges and recommendations <br>8.1 Medication shortages <br>8.2 Staffing and training/anesthesia workforce <br>8.3 Recommendations <br>8.4 Anesthesia management of high-risk pregnancies <br>8.5 Peripartum obstetric hemorrhage <br>8.6 Concept of the pregnancy heart team and cardiac obstetrics <br>8.7 Critical care in obstetrics <br>9. Enhanced recovery after CD <br>10. Process improvement to enhance patient safety in obstetric anesthesia <br>11. Handoffs and checklists <br>12. Simulation and team working in obstetric anesthesia <br>13. Racial disparities <br>14. Strategies to improve global inequities in obstetric anesthesia <br>15. Trauma informed care in obstetrics <br>References <br><br>7. Obstetric anesthesia consultation<br>Courtney Hood, Kristen L. Fardelmann and Benjamin Cobb<br><br>1. Indications for consultation <br>2. Components of consultation <br>3. Common indications for anesthesiology consultation <br>3.1 Anticoagulation <br>4. Thrombocytopenia <br>5. Placenta accreta spectrum (PAS) <br>6. Maternal cardiovascular disease <br>6.1 Interventions/ECMO <br>7. Spinal column/cord pathology, neurologic disease <br>8. Obesity <br>9. Opioid use disorder (OUD) <br>10. History of anesthetic complications <br>11. Consultation clinics <br>12. Conclusion <br>References <br><br>8. Obstetric management of labor and delivery, including preoperative assessment and basic standards for preanesthesia care<br>Huma Wali, Haneen Alnazzawi and Anjum Anwar<br><br>1. Introduction <br>2. CVD in the pregnant patient <br>3. Pregnancy counseling risk stratification <br>4. Mode and timing of delivery <br>5. Type of hospital and location within the hospital <br>6. Peripartum plan <br>7. The difficult airway in obstetrical anesthesia assessment <br>8. Preparation for difficult airway management <br>9. Difficult airway trolley <br>10. Difficult airway management <br>11. Simulation and training <br>12. Mental health and pregnancy <br>13. Management of psychiatric patients during pregnancy <br>14. Racial disparities in maternity care <br>15. Strategies for reducing disparities <br>15.1 Implementing protocols and safety bundles <br>16. Health care professionals&rsquo; education and communication <br>17. Outcome measurement, reviews, and community partnerships <br>18. Neuroobstetrics <br>19. Antenatal period/preconception <br>20. Intrapartum <br>21. Postpartum <br>22. Multiple sclerosis <br>23. Cerebrovascular diseases in pregnancy <br>24. Role of anesthesiologist in the management of stroke <br>25. Headache during pregnancy and postpartum <br>26. Evaluation of pregnant patients with headaches <br>27. Pregnancy and hematology <br>28. Iron-deficient anemia <br>29. Coagulation disorders <br>30. Hereditary coagulation disorders <br>31. Acquired coagulation disorders <br>32. Venous thromboembolism <br>32.1 Antepartum recommendations <br>32.2 Intrapartum recommendations <br>33. Respiratory diseases in pregnancy <br>34. Asthma <br>35. Respiratory failure <br>36. Obstructive sleep apnea <br>References <br><br>9. Fetal assessment and physiology<br>Mariana Montes, Chad T. Dean and Thomas James<br><br>1. Antenatal fetal assessment <br>2. Estimating gestational age <br>3. Routine ultrasonography <br>4. Evaluating the well-being of the fetus <br>4.1 Clinical assessment <br>5. Antepartum fetal testing <br>6. Fetal development and physiology <br>7. Fetal environment <br>8. Fetal cardiovascular system <br>9. Fetal respiratory system <br>10. Fetal hematologic system <br>11. Fetal neurologic system <br>12. Transition to the extrauterine environment <br>13. Physiologic changes in postnatal life <br>13.1 Cardiovascular and respiratory changes <br>14. Thermal regulation <br>15. Postnatal fetal assessment <br>16. APGAR score and umbilical cord gas and pH <br>References <br><br>10. Opioid analgesics in labor<br>Peter Louis Kovacs, Jayanth Dasika and Venkata Satya Lakshmi Damalanka<br><br>1. Introduction<br>2. Opioids<br>2.1 Mechanism of action<br>3. Pharmacokinetics<br>3.1 Absorption<br>3.2 Distribution<br>3.3 Biotransformation<br>3.4 Excretion<br>4. Effect on organ systems<br>4.1 Cardiovascular<br>4.2 Respiratory<br>4.3 Cerebral<br>4.4 Gastrointestinal<br>5. Plan for labor analgesia<br>6. Pharmacologic options for labor analgesia<br>7. Systemic analgesics<br>7.1 Opioid analgesia<br>8. Patient-controlled analgesia<br>8.1 Remifentanil PCA<br>8.2 Fentanyl PCA<br>8.3 Intermittent bolus opioid<br>8.4 Choice of opioid<br>8.5 Butorphanol<br>8.6 Fentanyl<br>8.7 Morphine<br>8.8 Meperidine<br>9. Regional analgesia<br>9.1 Neuraxial analgesia<br>9.2 Mechanism and site of action<br>9.3 Epidural opioids<br>9.4 Intrathecal opioids<br>10. Summary and conclusion<br>References<br><br>11. Mechanisms of labor pain and anesthesia in healthy parturients<br>Justin Swengel and Patrick McConville<br><br>1. Mechanisms of labor pain and its management<br>2. Nonpharmacologic treatment of pain<br>3. Pharmacologic techniques for labor pain control<br>3.1 Inhaled agents<br>3.2 Opioids <br>3.3 Neuraxial techniques<br>References <br><br>12. Nonopioid analgesia<br>Jayanth Dasika, Peter Louis Kovacs and Venkata Satya Lakshmi Damalanka<br><br>1. Nitrous oxide<br>2. Acetaminophen and nonsteroidal antiinflammatory drugs<br>3. Sedatives and analgesic adjuncts<br>References<br><br>13. Nonpharmacologic and alternative management of labor and delivery analgesia<br>David Gutman and Michael Marotta<br><br>1. Introduction<br>2. Water immersion<br>3. Biofeedback<br>4. Hypnosis<br>5. Acupuncture<br>6. Subcutaneous of intracutaneous sterile water injection<br>7. Manual/massage/reflexology<br>8. Conclusion <br>Reference <br><br>14. Local anesthetics and adjuvants in healthy obstetric patients<br>Jeffery Cao, Munfarid Zaidi, Lee Chang, Melissa Nikolaidis and Yi Deng<br><br>1. Introduction<br>2. Lidocaine<br>2.1 Mechanism of action<br>2.2 Clinical application<br>2.3 Side-effect profile<br>3. Ropivacaine<br>3.1 Mechanism of action<br>3.2 Clinical application<br>3.3 Side-effect profile<br>4. Bupivacaine<br>4.1 Mechanism of action<br>4.2 Clinical application<br>4.3 Side-effect profile<br>5. Chloroprocaine<br>5.1 Clinical application<br>5.2 Side-effect profile<br>6. Mepivacaine<br>6.1 Clinical application<br>6.2 Side-effect profile<br>7. Local anesthetic systemic toxicity<br>8. Adjuncts in neuraxial anesthesia<br>9. Epinephrine<br>10. Bicarbonate<br>11. Clonidine<br>12. Dexmedetomidine<br>13. Neostigmine<br>14. Magnesium<br>15. Experimental adjuncts<br>16. Opioids<br>17. Conclusion<br>References<br><br>15. Epidural anatomy and epidural anesthesia for labor and cesarean delivery<br>Fatoumata Kromah and Nicholas Malki<br><br>1. Introduction <br>2. Background <br>2.1 Epidural analgesia for labor and vaginal delivery <br>2.2 Epidurals for CD <br>3. Definition of topic <br>4. Issues related to this topic <br>5. Historical evolution/trends <br>6. Pathophysiology <br>6.1 Anatomy of the epidural space <br>7. Risk factors <br>8. Patient evaluation <br>9. Diagnosis <br>9.1 Medical History <br>9.2 Coagulation Status <br>9.3 Infection Control <br>9.4 Anatomical Considerations <br>9.5 Patient Preference and Informed Consent <br>9.6 Multidisciplinary Collaboration <br>10. Treatment <br>11. Anesthetic management <br>12. Pharmacology <br>13. Clinical issues or considerations <br>14. Prevention and self-care <br>15. Global impact and challenges <br>16. Future directions, novel treatments, and research studies <br>17. Summary/conclusion <br>18. Relevant images and tables <br>Abbreviations <br>References <br>Suggested readings <br><br><br>16. Neuraxial anesthesia for vaginal delivery<br>Kristin N. Bembenick, Angela Nguyen, Corrie Jackson, Sahar Shekoohi, Aaron J. Kaye, Alan D. Kaye and Harish Siddaiah<br><br>1. Introduction <br>2. Background <br>2.1 Epidural analgesia for labor and vaginal delivery <br>2.2 Epidurals for CD <br>3. Definition of topic <br>4. Issues related to this topic <br>5. Historical evolution/trends <br>6. Pathophysiology <br>6.1 Anatomy of the epidural space <br>7. Risk factors <br>8. Patient evaluation <br>9. Diagnosis <br>9.1 Medical History <br>9.2 Coagulation Status <br>9.3 Infection Control <br>9.4 Anatomical Considerations <br>9.5 Patient Preference and Informed Consent <br>9.6 Multidisciplinary Collaboration <br>10. Treatment <br>11. Anesthetic management <br>12. Pharmacology <br>13. Clinical issues or considerations <br>14. Prevention and self-care <br>15. Global impact and challenges <br>16. Future directions, novel treatments, and research studies <br>17. Summary/conclusion <br>18. Relevant images and tables <br>Abbreviations <br>References <br>Suggested readings <br><br>17. Neuraxial analgesia for cesarean delivery<br>Andrew Jensen, Kevin Chen, Melissa Nikolaidis and Yi Deng<br><br>1. Background <br>1.1 Cesarean delivery <br>1.2 Anesthesia with cesarean delivery <br>1.3 Trends in cesarean sections <br>2. The cesarean delivery <br>2.1 Indications <br>2.2 Contraindications <br>2.3 Degree of urgency <br>2.4 Risks <br>3. Anesthetic considerations for cesarean delivery: General anesthesia <br>3.1 Airway <br>3.2 Volatile anesthetics <br>3.3 Anterograde amnesia <br>4. Anesthetic considerations for the cesarean delivery: Neuraxial approach <br>4.1 Spinal <br>4.2 Epidural <br>4.3 Combined spinal and epidural <br>5. Acquiring the neuraxial blockade <br>5.1 Anatomic landmarks <br>5.2 Epidural placement <br>5.3 Procedural steps <br>5.4 Spinal placement <br>5.5 Procedural steps <br>5.6 Combine spinal-epidural placement <br>5.7 Procedural steps <br>5.8 Settings of placement <br>6. Diagnosing the coverage of neuraxial anesthesia <br>6.1 Appropriate coverage <br>6.2 Assessment using pinprick or temperature sensation <br>7. Troubleshooting inadequate coverage of neuraxial analgesia <br>7.1 Epidural management <br>7.2 Spinal management <br>8. Side effects of effective neuraxial block <br>8.1 Hypotension <br>8.2 Nausea <br>8.3 Shivering <br>9. The awake patient <br>9.1 Communication with parturient <br>9.2 Communication with other members of the medical team <br>9.3 Patient positioning <br>10. Global impact and challenges <br>11. Future directions, novel treatments, or research studies <br>References <br>Further reading <br><br>18. General anesthesia for normal, uncomplicated cesarean delivery: Indications and strategies<br>Fatoumata Kromah<br><br>1. Introduction <br>2. Background <br>3. Definition of the topic <br>3.1 General anesthesia <br>3.2 Cesarean delivery <br>4. Issues related to GA for the CD <br>4.1 Potential risks and side effects <br>4.2 Choice of anesthetic agents <br>4.3 RA versus GA <br>5. Historical evolution/trends <br>5.1 Early developments <br>5.2 Advent of RA <br>5.3 Shift from GA to RA <br>5.4 Current practices <br>6. Pathophysiology <br>6.1 Nervous system <br>6.2 Maternal physiology <br>6.3 Fetal physiology <br>6.4 Postoperative recovery <br>7. Risk factors <br>7.1 Maternal health conditions <br>7.2 Obstetric complications <br>7.3 Fetal health concerns <br>7.4 Specific perioperative risks <br>8. Patient evaluation <br>8.1 History taking <br>8.2 Physical examination <br>8.3 Relevant investigations <br>9. Diagnosis <br>10. Treatment <br>10.1 Preoperative preparation <br>10.2 Preoxygenation and preinduction <br>10.3 Induction and intubation <br>10.4 Maintenance and emergence <br>10.5 Postoperative care <br>11. Anesthetic management <br>11.1 Preoperative preparation <br>11.2 Intraoperative management <br>11.3 Postoperative management <br>12. Pharmacology <br>13. Clinical issues or considerations <br>13.1 Urgent versus elective CD <br>13.2 Patient preference <br>13.3 General health status <br>14. Prevention and self-care <br>15. Global impact and challenges <br>16. Future directions, novel treatments, and research studies <br>16.1 Improved monitoring techniques <br>16.2 Novel anesthetic agents <br>16.3 Enhanced recovery after surgery protocols <br>16.4 Telemedicine and digital health <br>16.5 Research on long-term impacts <br>17. Summary and conclusion <br>Abbreviations <br>References <br>Additional suggested readings<br> <br>19. Airway management of the pregnant patient for labor and cesarean delivery<br>Moataz Maher Emara, Mohamed Maher Elwaraky, Laila Alhafez and Sally Hamdy Abdelaziz Ahmed<br><br>1. Incidence of GA and difficult airways in the obstetric population <br>2. Physiological changes during pregnancy: Implications on airway management <br>2.1 Respiratory parameters and gas exchange alterations <br>2.2 Airway obstruction and difficulty in intubation <br>2.3 Gastric emptying and aspiration risk <br>2.4 Pharmacological considerations <br>3. Evaluation and prediction of difficult airway <br>4. Maternal complications related to airway management <br>4.1 Aspiration pneumonitis <br>4.2 Bronchospasm <br>4.3 Post-extubation hypoventilation <br>4.4 Accidental awareness <br>5. Suggested protocol for airway management in pregnant women <br>5.1 Preparation of the parturient <br>5.2 Preparation of equipment and personnel <br>5.3 Positioning <br>5.4 Preoxygenation/apneic oxygenation <br>5.5 Rapid sequence induction <br>5.6 Induction and neuromuscular drugs <br>5.7 Cricoid pressure <br>5.8 Laryngoscopes <br>5.9 Tracheal extubation <br>6. Guidelines for difficult airway in pregnant women (UK-OAA/DAS) <br>6.1 Anticipated difficult intubation <br>6.2 Unanticipated difficult or failed intubation <br>6.3 Direct and indirect (video) laryngoscopy direct laryngoscopy <br>6.4 Obstetric Anesthetists&rsquo; Association and Difficult Airway Society guidelines <br>6.5 Other relative guidelines <br>References <br><br>20. Postoperative pain management for cesarean delivery<br>Antonio Gonzalez Fiol, P.J. McGuire, Kristen L. Fardelmann and Aymen Awad Alian<br><br>1. Acute pain after cesarean delivery <br>2. Neuraxial anesthesia and adjuvant drugs <br>2.1 Multimodal analgesia <br>2.2 Shared decision-making for pain management in the postpartum period <br>2.3 Opioid-sparing multimodal analgesia (OSMMA) <br>3. Opioid analgesics <br>4. Enhanced Recovery After Cesarean (ERAC) <br>4.1 Racial and ethnic disparities <br>5. General anesthesia <br>6. Local and regional analgesia techniques <br>7. Acute pain management for the patient with substance use disorder (SUD) <br>References <br> <br>21. Postoperative sterilization surgery and anesthesia considerations<br>Melissa Nikolaidis, Jacy Gressen, Tommy Li and Yi Deng<br><br>1. Introduction: Postpartum birth control <br>1.1 The advantages of postpartum birth control preplanning <br>2. Methods for immediate postpartum contraception <br>2.1 Reversible contraception <br>2.2 Irreversible contraception <br>3. Current policies affecting postpartum sterilization <br>4. Postpartum sterilization procedure <br>4.1 Surgical considerations <br>4.2 Anesthetic considerations <br>5. Postsurgical sterilization pain management <br>6. Chapter summary <br>References <br><br>22. Anesthesia for assisted reproductive techniques<br>Fouzia Khalid and Amber Naz<br><br>1. Introduction <br>1.1 What is assisted fertilization <br>1.2 Ovum retrieval done through <br>1.3 Sperm collection <br>1.4 Patient preparation <br>1.5 Does ART procedure need anesthesia? <br>1.6 Conscious sedation <br>2. General anesthesia <br>2.1 Propofol <br>2.2 Thiopental <br>2.3 Ketamine <br>2.4 Etomidate <br>2.5 Inhalational anesthesia <br>2.6 Benzodiazepine <br>2.7 Dexmedetomidine <br>2.8 Opioids <br>2.9 Non-opioid analgesic <br>2.10 Antiemetics <br>2.11 Neuraxial anesthesia <br>2.12 Paracervical block <br>2.13 Patient controlled analgesia <br>2.14 Newer techniques <br>2.15 Complications associated with assisted fertilization <br>2.16 Ovarian hyperstimulation syndrome <br>2.17 Ectopic pregnancy <br>2.18 Multiple gestation <br>References <br><br>23. Anesthesia considerations for pregnant patients with cardiovascular disease<br>Islam Mohammad Shehata Elsayed, Yasmeen Ahmed Mohamed Taha, Hala Mostafa Goma and Nesrine Abdel Rahman Elrefai<br><br>1. Cardiac diseases in pregnancy <br>2. Common risk factors of cardiac disease in pregnancy <br>3. Types of cardiac diseases in pregnancy <br>4. Risk classification of the patient with cardiac diseases <br>5. General considerations of cardiac parturients <br>6. Preoperative evaluation of cardiac pregnant patient <br>7. History <br>8. Preoperative clinical assessment <br>8.1 Cardiac tests during pregnancy <br>9. Preoperative considerations for specific cardiac lesions <br>9.1 Congenital heart diseases <br>9.2 Arrhythmia <br>9.3 Prosthetic heart valves <br>10. Rheumatic valvular disease <br>10.1 Mitral stenosis (MS) <br>10.2 Mitral or aortic regurgitation <br>10.3 Myocardial infarction <br>11. Peripartum cardiomyopathy <br>11.1 Cardiac tests for diagnosis of peripartum cardiomyopathy <br>12. Preoperative preparation of cesarean section <br>12.1 Monitoring for cesarean delivery <br>13. Anesthesia techniques <br>13.1 Regional anesthesia <br>14. Anticoagulant therapy considerations <br>14.1 The cardiovascular effects of regional anesthesia <br>14.2 The type and severity of cardiac illness <br>14.3 How to conduct safe neuraxial anesthesia <br>15. Postpartum care <br>16. Conclusion <br>References <br><br>24. Anesthesia considerations for pregnant patients with lung disease<br>Adam Lin Wendling and Clinton Pillow<br><br>1. Introduction <br>2. Background <br>3. Issues related to this topic <br>4. Historical evolution/trends <br>5. Pathophysiology <br>6. Risk factors <br>6.1 Preexistent pulmonary disease <br>6.2 Acquired pulmonary disease <br>7. Patient evaluation <br>7.1 History <br>7.2 Physical <br>7.3 Confirmatory tests <br>8. Diagnosis <br>8.1 Obstructive lung disease <br>8.2 Restrictive lung disease <br>8.3 Respiratory tract infections <br>8.4 ARDS <br>9. Treatment <br>9.1 Asthma <br>9.2 Cystic fibrosis <br>10. Anesthetic management <br>10.1 General principles <br>11. Global impact and challenges <br>12. Future directions, novel treatments, or research studies <br>13. Summary and conclusion <br>References <br><br>25. Anesthesia considerations for patients with renal, hematologic, connective tissue, and immunologic diseases<br>Rucha A. Kelkar, Alexandra D. Dautel, Lillian V. Lauck, Michael J. Quintana, Sahar Shekoohi and Alan David Kaye<br><br>1. Introduction <br>2. Renal considerations <br>2.1 Definition, background, related issues, historical trends <br>2.2 Pathophysiology <br>2.3 Risk factors <br>2.4 Patient evaluation, diagnosis, treatment <br>2.5 Anesthetic management, pharmacology <br>3. Hematologic considerations <br>3.1 Definition, background, related issues, historical trends <br>3.2 Pathophysiology <br>3.3 Risk factors <br>3.4 Patient evaluation, diagnosis, treatment <br>3.5 Anesthetic management, pharmacology <br>3.6 Clinical issues/considerations, prevention, self-care <br>3.7 Global impact and challenges <br>4. Connective tissue considerations <br>4.1 Definition, background, related issues, historical trends <br>4.2 Pathophysiology <br>4.3 Anesthetic management and risk management <br>4.4 Patient evaluation, clinical issues/considerations, prevention <br>5. Immunologic considerations <br>5.1 Definition, background, related issues, historical trends <br>5.2 Pathophysiology <br>5.3 Risk factors <br>5.4 Patient evaluation, diagnosis, treatment <br>5.5 Anesthetic management, pharmacology <br>5.6 Clinical issues/considerations, prevention, self-care <br>5.7 Global impact and challenges <br>6. Future directions, novel treatments, or research studies <br>7. Summary and conclusion <br>References <br><br>26. Anesthesia considerations for parturients with endocrine disorders<br>Evan Nicholas Lian, Asher Le and Aladino De Ranieri<br><br>1. Introduction <br>2. Diabetes mellitus <br>2.1 Anesthetic implications <br>3. Thyroid disease <br>3.1 Hyperthyroidism <br>3.2 Hypothyroidism <br>3.3 Temperature regulation <br>4. Pituitary disease <br>4.1 Acromegaly <br>5. Adrenal disease <br>5.1 Cushing syndrome <br>5.2 Adrenocortical insufficiency <br>5.3 Pheochromocytoma <br>References <br><br>27. Anesthetic considerations for patients with neurologic disorders in pregnancy<br>Philip Rubin and Lisa Leffert<br><br>1. Introduction <br>2. Background <br>3. Case #1 <br>3.1 Historical evolution/trends <br>3.2 Pathophysiology <br>3.3 Risk factors <br>3.4 Patient evaluation/diagnosis <br>3.5 Treatment/surgical correction <br>3.6 Impact on pregnancy <br>4. Case #2 <br>4.1 Historical evolution/trends <br>4.2 Pathophysiology <br>4.3 Risk factors <br>4.4 Treatment <br>4.5 Impact of pregnancy <br>5. Case #3 <br>5.1 Pathophysiology <br>5.2 Risk factors <br>5.3 Patient evaluation/diagnosis <br>5.4 Treatment <br>5.5 Impact on pregnancy <br>6. Case #4 <br>6.1 Historical evolution/trends <br>6.2 Pathophysiology <br>6.3 Impact on pregnancy <br>7. Conclusion <br>References <br><br>28. Anesthesia considerations for fetal growth restriction and macrosomia in pregnancy<br>Kylie Dufrene, James Ilochi, Caleigh Foto, Julia Hebert, Carlos Narvaez, Sahar Shekoohi and Alan David Kaye<br><br>1. Fetal macrosomia <br>2. Obstetric anesthesia considerations complicated by macrosomia and fetal growth restriction <br>2.1 Anesthesia considerations for a cesarean birth <br>2.2 Anesthesia considerations for conversion from vaginal to cesarean birth <br>2.3 Pregnancy complications related to fetal growth outcomes and anesthesia considerations <br>2.4 Intraoperative complications <br>2.5 Intraoperative complications associated with FGR <br>2.6 Intraoperative complications associated with macrosomia <br>3. Common intraoperative complications in both conditions <br>3.1 Blood loss and hemorrhage <br>3.2 Amniotic fluid embolism <br>3.3 Monitoring and management strategies <br>3.4 Fetal growth restriction: Definition, diagnosis, and anesthetic implications <br>3.5 Anesthetic considerations for FGR <br>3.6 Optimal timing for induction in FGR <br>3.7 Minimizing risks and enhancing safety <br>3.8 Anesthetic agent teratogenicity <br>References <br><br>29. Anesthesia considerations for pregnant patients with morbid obesity and neoplasm<br>Erica Johnson, Teshi Kaushik and Christina Faya<br><br>1. Introduction and background <br>1.1 Definition <br>2. Issues related to maternal obesity <br>3. Pathophysiology <br>3.1 Effect of obesity on the respiratory system <br>3.2 Effect of obesity on the cardiovascular system <br>3.3 Effect of obesity on the gastrointestinal system <br>4. Anesthetic management <br>4.1 Preoperative assessment <br>4.2 Preoperative counseling <br>4.3 Monitors and access <br>5. Labor analgesia <br>5.1 Equipment set up <br>5.2 Patient positioning <br>5.3 Epidural versus DPE versus CSE for labor analgesia <br>5.4 Epidural catheter dislodgement <br>5.5 Initiation of epidural analgesia-Local anesthetic pharmacology <br>6. Anesthesia for cesarean delivery <br>6.1 General considerations for anesthesia for cesarean delivery <br>7. Neuraxial anesthesia for cesarean delivery <br>7.1 Spinal anesthesia <br>7.2 Combined spinal epidural anesthesia <br>7.3 Continuous spinal anesthesia <br>7.4 Local anesthetic dosage <br>7.5 Phenylephrine dosage <br>7.6 Postdural puncture headache <br>8. General anesthesia for cesarean delivery <br>8.1 Unique challenges for general anesthesia for C-sections <br>9. Postoperative pain management <br>10. Summary and conclusion <br>10.1 Neoplasm in pregnancy <br>References <br>Further reading <br> <br>30. Anesthesia considerations for parturients with substance abuse or psychiatric disorders<br>Justin Swengel and Patrick McConville<br><br>1. Psychiatric disease and substance abuse in the parturient 313<br>2. Psychiatric diseases 313<br>3. Depression 313<br>4. Anxiety 315<br>5. Bipolar disorder 316<br>6. Schizophrenia 317<br>7. Substance use and abuse 318<br>8. Licit drugs 318<br>8.1 Tobacco 318<br>8.2 Alcohol 319<br>8.3 Caffeine 320<br>9. Illicit drugs 320<br>9.1 Marijuana 320<br>9.2 Cocaine 321<br>9.3 Amphetamines 321<br>9.4 Opioids 322<br>9.5 Hallucinogens 324<br>References 325<br>Further reading 326<br><br>31. Opioid use disorder in pregnancy<br>Sonal Zambare, Lauren Brown-Berchtold and Amy I. Lee<br><br>1. Introduction <br>2. Historical evolution and trends <br>3. Pregnancy and opioid use <br>4. Treatment of opioid use disorder <br>5. Pharmacology <br>5.1 Buprenorphine <br>5.2 Methadone <br>5.3 Naltrexone <br>6. Challenges in managing patients with an opioid use disorder <br>7. Barriers to effective analgesia <br>7.1 Antenatal considerations <br>7.2 Labor analgesia <br>7.3 Anesthesia and analgesia for cesarean delivery <br>8. Teams involved in managing patients with OUD <br>9. Neonatal effects <br>10. Breastfeeding <br>11. Conclusion <br>References <br><br>32. Anesthesia considerations for patients with renal, hematologic, connective tissue, and immunologic diseases<br>Adam Lin Wendling and Seth Garrett<br><br>1. Introduction <br>2. Issues related to this topic <br>2.1 Renal disease <br>2.2 Selected pathophysiologic conditions leading to AKI and CKD <br>2.3 Treatment for renal disorders <br>3. Immunologic disease <br>3.1 Background <br>3.2 Historical evolution/trends <br>3.3 Multiple sclerosis and the related condition neuromyelitis optica <br>3.4 Myasthenia gravis (MG) <br>3.5 Rheumatoid arthritis (RA) <br>3.6 Systemic lupus erythematosus <br>3.7 Sjogren&rsquo;s syndrome <br>3.8 Systemic sclerosis/scleroderma <br>3.9 Inflammatory bowel disease (IBD) <br>3.10 Autoimmune hepatitis (AIH) <br>4. Connective tissue diseases <br>4.1 Background <br>4.2 Historical evolution/trends <br>4.3 Selected connective tissue disorders with significant impact on obstetric and perioperative management <br>5. Hematologic complications of pregnancy <br>5.1 Background <br>5.2 Historical evolution/trends <br>5.3 Selected hematologic disorders with significant impact on obstetric and perioperative management <br>5.4 Thrombocytopenia <br>5.5 Immune thrombocytopenia (ITP) <br>5.6 Hypertensive disease of pregnancy <br>6. Coagulation disorders <br>6.1 VWD <br>6.2 Acquired hemophilia <br>6.3 Procoagulant disorders <br>7. Future directions, novel treatments, or research studies <br>8. Summary and conclusion <br>References <br><br>33. Anesthesia considerations for patients with COVID-19<br>Nesrine Refai, Hala Mostafa Goma, Islam Mohammad Shehata Elsayed and Ahmed Hashim<br><br>1. Introduction <br>2. Pathophysiology <br>3. Risk factors <br>4. Diagnosis <br>5. Treatment <br>5.1 Preoperative assessment of COVID pregnant patient <br>5.2 Exclusion of acute phase of COVID infection <br>6. A respiratory complication of COVID-19 which indicates pre- or postoperative ventilation <br>7. Early diagnosis of pulmonary embolism <br>7.1 Preoperative medications <br>8. Preoperative assessment of intrauterine fetus <br>9. How to improve oxygenation in COVID-19 pregnant patient <br>9.1 Methods of improving oxygenation <br>9.2 High-flow nasal cannula <br>10. Noninvasive positive pressure ventilation <br>11. Extracorporeal membrane oxygenation <br>11.1 Preparation of the operating room for COVID patients <br>11.2 Equipments <br>11.3 Personal protection <br>References <br><br>34. Anesthesia considerations for patients with preeclampsia<br>Alexandra Waits, Kennedy Kirkpatrick, Melissa Nikolaidis and Yi Deng<br><br>1. History of preeclampsia <br>2. Epidemiology <br>3. Pathophysiology <br>4. Histologic findings <br>5. Risk factors for preeclampsia development <br>6. Diagnostic criteria and clinical presentation <br>7. Morbidity and mortality <br>8. Risk stratification <br>9. Healthcare economic burden <br>10. Treatment of hypertensive disorders of pregnancy <br>11. Anesthetic considerations in preeclampsia <br>11.1 Cardiovascular <br>11.2 Fluid management <br>11.3 Neuraxial anesthesia <br>11.4 General anesthesia <br>11.5 Regional techniques <br>11.6 Uterotonic agents <br>11.7 Eclampsia management <br>References <br><br>35. Anesthesia considerations for patients with infections, HIV, and sexually transmitted diseases<br>Claudia Wei and Amy I. Lee<br><br>1. Introduction <br>2. Bacterial infections <br>2.1 General considerations <br>2.2 Anesthetic management of the septic parturient <br>3. Viral infections <br>3.1 Human immunodeficiency virus <br>3.2 Coronavirus disease 2019 <br>3.3 Herpes simplex virus <br>3.4 Human papilloma virus <br>3.5 Hepatitis <br>3.6 Varicella <br>3.7 Others-cytomegalovirus, rubella, measles <br>4. Conclusion <br>References <br><br>36. Anesthesia considerations with multiple births and fetal malpresentation<br>Joseph Bavaro, Candice Cuppini and Andrew Hallmark<br><br>1. Anesthesia considerations for multiple births <br>1.1 Introduction <br>1.2 Definitions/epidemiology <br>1.3 Maternal physiologic changes <br>1.4 Fetal morbidity in multiple gestation <br>1.5 Anesthetic management <br>2. Anesthesia for fetal malpresentation <br>2.1 Definitions and epidemiology <br>2.2 Obstetric considerations <br>2.3 Anesthetic considerations <br>References <br><br>37. Anesthesia considerations for vaginal birth after C-section, and for abnormalities of the reproductive tract<br>Emily Dinges<br><br>1. Trial of labor after cesarean <br>1.1 Introduction <br>1.2 Background <br>1.3 Historical evolution and trends <br>1.4 Issues related to this topic <br>1.5 Anesthetic management <br>1.6 Other causes of uterine rupture <br>2. Abnormalities of the reproductive tract <br>2.1 Hymen malformations <br>2.2 Mullerian anomalies <br>2.3 Mullerian anomalies and effects on reproduction <br>2.4 Anesthetic considerations <br>References <br><br>38. Anesthetic considerations for nonobstetric surgery during pregnancy<br>Kristin Horton and Mary Lynne Roberts<br><br>1. Introduction <br>2. Brief review of physiologic changes in pregnancy <br>2.1 Cardiovascular <br>2.2 Hematology <br>2.3 Pulmonary <br>2.4 Airway <br>2.5 Gastrointestinal <br>2.6 Neurologic and neuromuscular <br>2.7 Endocrine <br>2.8 Pharmacologic <br>2.9 Uteroplacental blood flow <br>2.10 Summary of physiologic changes <br>3. Preoperative assessment and management <br>3.1 Risks of surgery and general anesthesia during pregnancy <br>3.2 Timing of surgery <br>3.3 Choosing anesthetic type <br>3.4 Monitoring <br>3.5 Patient assessment <br>3.6 Premedications <br>3.7 Pain control and multimodal analgesia <br>3.8 Aspiration prophylaxis <br>3.9 Other medications <br>4. Intraoperative management <br>4.1 Positioning <br>4.2 Induction/airway <br>4.3 Hemodynamic and respiratory goals <br>4.4 Anesthetic medications and the fetus <br>4.5 Maternal code blue <br>4.6 Considerations for surgical subspecialty procedures <br>5. Postoperative management <br>5.1 Postoperative monitoring <br>5.2 Imaging <br>5.3 Pain management <br>6. Summary <br>References <br><br>39. Anesthesia considerations for rare obstetric procedures: Cerclage placement, external cephalic version, and fetal intrauterine procedures<br>Hani El-Omrani, Thanh-Giang Vu and Emily Dinges<br><br>1. Cerclage <br>1.1 Background <br>1.2 Types of cerclage <br>1.3 Methods of cerclage placement <br>1.4 Anesthesia for cerclage placement <br>1.5 Cerclage removal <br>2. External cephalic version <br>2.1 Introduction <br>2.2 The impact of regional anesthesia or analgesia on ECV outcomes <br>2.3 Recommendations for regional anesthetic or analgesic techniques for ECV <br>2.4 Summary <br>3. Fetal intrauterine procedures <br>3.1 Operative techniques <br>3.2 Common indications <br>3.3 Anesthesia considerations <br>References <br><br>40. Anesthesia considerations for patients with spine surgery<br>Alan David Kaye, Rucha A. Kelkar, Alexandra D. Dautel, Lillian V. Lauck, Michael J. Quintana, Shahab Ahmadzadeh and Sahar Shekoohi<br><br>1. Introduction <br>2. Pathophysiology, diagnosis, and treatment <br>2.1 Scoliosis <br>2.2 Discectomy and laminectomy <br>2.3 Chronic spinal cord injury <br>2.4 Spinal dysraphism <br>2.5 Implantable devices <br>3. Patient evaluation <br>4. Anesthetic management <br>4.1 The use of neuraxial ultrasound <br>4.2 Considerations for scoliosis <br>4.3 Considerations for chronic spinal cord injury <br>4.4 Considerations for spinal dysraphism <br>4.5 Considerations for the presence of implantable devices <br>4.6 Considerations for failed neuraxial and operative delivery <br>5. Future directions <br>6. Conclusion <br>References <br><br>41. Anesthesia considerations for patients with special spine considerations including chronic spinal cord injury, spinal dysraphism, and implantable devices<br>Mikayla Troughton, Helen Pappas and Carmen Lopez<br><br>1. Introduction <br>2. Pathophysiology, diagnosis, and treatment <br>2.1 Scoliosis <br>2.2 Discectomy and laminectomy <br>2.3 Chronic spinal cord injury <br>2.4 Spinal dysraphism <br>2.5 Implantable devices <br>3. Patient evaluation <br>4. Anesthetic management <br>4.1 The use of neuraxial ultrasound <br>4.2 Considerations for scoliosis <br>4.3 Considerations for chronic spinal cord injury <br>4.4 Considerations for spinal dysraphism <br>4.5 Considerations for the presence of implantable devices <br>4.6 Considerations for failed neuraxial and operative delivery <br>5. Future directions <br>6. Conclusion <br>References <br><br>42. Peripartum hemorrhage and management<br>Dana Darwish, Christopher Choi and Faiza A. Khan<br><br>1. Overview <br>2. Causes <br>3. Management of PPH <br>3.1 Stages of hemorrhagic shock <br>3.2 Transfusion protocols and use of TXA <br>3.3 Medical management <br>3.4 Surgical management <br>3.5 Anesthetic evaluation and management <br>4. Anesthetic management <br>4.1 Preoperative checklist <br>4.2 Anesthetic induction and maintenance <br>4.3 Anesthetic risks and complications <br>4.4 Complications of postpartum hemorrhage <br>5. Special considerations: Placenta accrete spectrum <br>5.1 Anesthetic management <br>6. Conclusion <br>References <br><br>43. Point-of-care coagulation testing for obstetric hemorrhage<br>Elvera L. Baron and Daniel Katz<br><br>1. Postpartum hemorrhage (PPH) and need for point-of-care (POC) coagulation testing <br>2. Hemostasis: Normal pregnancy as compared to patients with PPH <br>3. Viscoelastic testing: ROTEM, TEG, others <br>3.1 Identification of hemostatic changes in pregnancy <br>3.2 Identification of clinical coagulopathy <br>4. Advantages of VTs <br>5. Disadvantages and limitations of viscoelastic tests <br>6. Other viscoelastic tests and new machines <br>7. Conclusion <br>References <br><br>44. Trauma during pregnancy<br>Joseph Abro, Grayce Davis, Rishi Patel and Travis Pecha<br><br>1. Epidemiology <br>2. Maternal complications and outcomes <br>3. Fetal complications and outcomes <br>4. Assessment and resuscitation in pregnancy <br>4.1 Primary survey <br>4.2 Secondary survey <br>4.3 Cardiopulmonary resuscitation <br>5. Critical care during pregnancy <br>5.1 Preeclampsia/eclampsia <br>5.2 Amniotic fluid embolism <br>5.3 Cardiomyopathy in pregnancy <br>5.4 Hemorrhagic shock in pregnancy <br>5.5 Sepsis <br>5.6 PRES <br>References<br> <br>45. Postdural puncture headaches<br>Peter Arrabal, John Crowe, Andrea Girnius and Michael Hawryschuk<br><br>1. Introduction <br>2. Pathophysiology <br>3. Incidence and risk factors <br>4. Prevention of PDPH after unintentional dural puncture <br>5. Clinical features and diagnosis of PDPH <br>6. Treatment options <br>6.1 Epidural blood patch <br>6.2 Other treatments for PDPH <br>7. Long-term outcomes <br>8. Summary <br>References <br><br>46. Fetal and neonatal assessment of complications and injuries (including abnormal labor, dystocia abnormalities of expulsive forces, abnormal presentation, position and development, and pelvic contraction)<br>Anusha Kallurkar, Jackie Hanners, Kristina Gambino and Dani Zoorob<br><br>1. Abnormal fetal presentation <br>1.1 Occiput-posterior (OP) presentation <br>2. Abnormal fetal testing <br>2.1 Tachysystole <br>2.2 Maternal hypotension <br>3. Labor complications <br>3.1 Cord prolapse <br>3.2 Chorioamnionitis <br>3.3 Uterine rupture <br>3.4 Uterine inversion <br>4. Delivery complications <br>4.1 Operative vaginal deliveries <br>4.2 Shoulder dystocia <br>5. Conclusion <br>References <br><br>47. Hypotension and hypertension in pregnancy<br>Daniel Hernandez-Barajas, Brooke Ingram Tsao and Jose Humanez<br><br>1. Hypotensive disease of pregnancy <br>1.1 Introduction <br>2. Background <br>2.1 Definition of hypotension in obstetric patients <br>2.2 Issues related to this topic <br>2.3 Pathophysiology of hypotension in obstetrics <br>3. Risk factors <br>4. Patient evaluation <br>5. Diagnosis <br>6. Treatment <br>6.1 Left uterine displacement <br>7. Anesthetic management <br>8. Prevention <br>9. Global impact and challenges <br>10. Gestation hypertension and preeclampsia <br>11. Preeclampsia <br>12. Diagnostic criteria of preeclampsia <br>12.1 Hypertension <br>12.2 Proteinuria <br>12.3 Thrombocytopenia <br>12.4 Renal insufficiency <br>12.5 Impaired liver function <br>12.6 Abdominal pain <br>12.7 Pulmonary edema <br>12.8 Headache <br>13. Hemolysis, elevated liver enzymes, and low platelet count syndrome <br>14. Eclampsia <br>15. Gestational hypertension <br>16. Pathophysiology <br>17. Clinical recommendations and treatment <br>18. Anesthetic management <br>References <br><br>48. Pulmonary aspiration and interventions to reduce the risk of aspiration<br>Jason Gabriel Hirsch<br><br>1. Background <br>2. History <br>3. Incidence <br>4. Physiology of pregnancy <br>5. Risk factors <br>6. Pathophysiology <br>7. Management <br>8. Prevention <br>References <br><br>49. Amniotic fluid embolism<br>Brooke Ingram Tsao and Grace Cruz<br><br>1. Introduction <br>2. Incidence <br>3. Diagnosis <br>3.1 Disseminated intravascular coagulation <br>3.2 Differential diagnosis <br>4. Risk factors <br>5. Pathophysiology <br>6. Pharmacology and treatment <br>7. Anesthesia considerations <br>References <br><br>50. Intraamniotic infection<br>Lauren Brown-Berchtold and Sterling Adams<br><br>1. Introduction <br>2. Historical evolution <br>3. Pathophysiology <br>3.1 Microbiology <br>3.2 Risk factors <br>4. Patient evaluation <br>4.1 Initial evaluation <br>4.2 Clinical history <br>4.3 Physical examination <br>4.4 Laboratory testing <br>4.5 Imaging <br>5. Diagnosis <br>5.1 Steroids and leukocytosis <br>6. Treatment <br>6.1 Intrapartum <br>6.2 Length of antibiotic therapy <br>6.3 Isolated maternal fever considerations <br>7. Prevention <br>8. Clinical considerations <br>8.1 Dysfunctional labor <br>8.2 Maternal outcomes <br>8.3 Neonatal outcomes <br>9. Anesthetic management <br>10. Conclusion <br>References <br><br>51. Preterm birth<br>Edward Springel, Arunthevaraja Karuppiah, Miheret Yitayew, Nayef Chahin, Jenny R. Fox and Joseph A. Khoury<br><br>1. Epidemiology of preterm birth <br>2. Risk factors for preterm birth <br>3. Pathophysiology of preterm birth <br>4. Prediction of preterm birth <br>5. Obstetric strategies to reduce risk of preterm birth and improve outcomes of premature neonates <br>5.1 Primary prevention of preterm birth <br>5.2 Secondary prevention of preterm birth <br>5.3 Tertiary prevention of preterm birth <br>6. Measures to improve neonatal outcome <br>6.1 Betamethasone <br>6.2 Magnesium sulfate for neuroprotection <br>6.3 Antibiotics <br>7. Anesthesia impact on fetal heart rate monitoring <br>7.1 Fetal heart rate monitoring in preterm fetus <br>7.2 Impact of perinatal anesthesia on the newborn <br>7.3 Analgesia for preterm labor and vaginal delivery <br>7.4 Anesthesia for cesarean delivery <br>7.5 Interactions between tocolytic therapy and anesthesia <br>References <br> <br>52. Neurologic complications from regional anesthesia and general anesthesia in obstetric practice<br>Carmen Lopez, Mikayla Troughton and Emery McCrory<br><br>1. Introduction <br>2. Peripheral nerve injury <br>2.1 Mechanism <br>2.2 Risk factors <br>2.3 Lateral femoral cutaneous nerve <br>2.4 Femoral nerve <br>2.5 Obturator nerve <br>2.6 Lumbosacral plexus <br>2.7 Common peroneal nerve <br>2.8 Treatment and prevention <br>3. Central nervous injury <br>3.1 Unintentional dural puncture and postdural puncture headache <br>3.2 Cerebral vein thrombosis <br>3.3 Spinal cord trauma <br>3.4 Anterior spinal artery syndrome <br>3.5 Spinal epidural hematoma <br>3.6 Epidural abscess <br>3.7 Chemical injury and arachnoiditis <br>3.8 Transient neurological symptoms <br>4. Neurological complications from general anesthesia <br>4.1 Ulnar nerve <br>4.2 Brachial plexus <br>4.3 Common peroneal nerve <br>References <br><br>53. Intraoperative and postoperative anesthesia-related morbidity and mortality, extremes of reproductive life, and abortion<br>Alexander M. Aldanese, Fadi M. Huzien, Denver Stutler, Nikole K. Nikolov, Kylie Dufrene, Aaron J. Kaye, Harish Siddaiah, Sahar Shekoohi and Alan David Kaye<br><br>1. Introduction <br>2. Anesthetic causes of maternal mortality <br>2.1 Management of the difficult airway in obstetrics <br>2.2 Aspiration of gastric acid <br>2.3 Maternal mortality and the complex landscape of local anesthetic toxicity <br>2.4 Obstetric anesthesiologic mortality due to high spinal or epidural block: a comprehensive analysis <br>3. Anesthetic causes of maternal morbidity <br>3.1 Postdural puncture headache <br>3.2 Postpartum neurologic deficits and related pathophysiology <br>3.3 Postpartum back pain <br>3.4 Common complications of extreme maternal ages and anesthesia management <br>3.5 Anesthetic complications during a cesarean section <br>3.6 Intrapartum and postpartum hemorrhage <br>3.7 Effect of anesthesia on preeclampsia and eclampsia <br>3.8 Anesthesia in preterm labor <br>3.9 Common complications of anesthesia use during abortive procedures <br>4. Conclusion <br>References <br><br>54. Anesthesia for fetal surgery<br>Kylie Dufrene, Alexandra Dicke, Van Smith III, James Ilochi, John David Sawyer, Sahar Shekoohi and Alan David Kaye<br><br>1. Indications for fetal surgery <br>2. Anesthesia considerations in fetal surgery <br>2.1 Minimally invasive surgery <br>2.2 Open fetal surgery <br>2.3 Exit procedure <br>3. Anesthetic considerations for fetal surgery <br>3.1 Epidural <br>3.2 Regional anesthesia <br>3.3 General anesthesia <br>3.4 Gestational age considerations <br>3.5 Intraoperative fetal monitoring during fetal surgery <br>3.6 Rationale for fetal monitoring <br>3.7 Monitoring parameters and interpretation <br>3.8 Challenges and considerations <br>References <br><br>55. Obstetric anesthesia and medicolegal/ethical issues<br>Alan David Kaye, Angela Nguyen, Emily Dantes, Cameron Robicheaux, Julia Trettin, Kylie Dufrene, Aaron J. Kaye, Sahar Shekoohi and Harish Siddaiah<br><br>1. Introduction <br>2. Physiological changes in pregnancy relevant to anesthesia <br>3. Standard obstetric anesthesia techniques <br>4. Anesthetic management of obstetric complications <br>5. Medicolegal and ethical considerations in obstetric anesthesia <br>6. Informed consent in obstetric anesthesia <br>7. Liability issues in obstetric anesthesia <br>8. Ethical dilemmas in obstetric anesthesia <br>9. Cultural and religious considerations <br>10. Patient advocacy and rights <br>11. Future direction and innovations in obstetric anesthesia <br>12. Summary and conclusion <br>References <br><br>56. Fetal evaluation, including the premature fetus and the compromised fetus<br>Hamdy Bakry Alqenawy, Mohamed Elmezaien, Rania Gamal El-Skaan and Mohamad Ismail<br><br>1. Antenatal surveillance <br>1.1 Fetal movement count <br>1.2 Fetal heart rate-based tests <br>1.3 Imaging-based tests <br>2. Intrapartum fetal heart rate monitoring <br>2.1 NICHD classification, interpretation, and management of FHR patterns <br>3. Anesthesia in special situations <br>3.1 Twin to twin transfusion syndrome <br>3.2 External cephalic version <br>3.3 Shoulder dystocia <br>3.4 Intrauterine transfusion <br>References <br><br>57. Fetal and neonatal complications and treatment, including resuscitation<br>Jenny R. Fox, Kelly Stanley, Edward Springel, Fatoumata Kromah and Joseph A. Khoury<br><br>1. Introduction <br>2. Antepartum management <br>2.1 Fetal heart rate monitoring <br>2.2 Rapid clinical assessment of suspected fetal hypoxemia and acidosis <br>2.3 Maternal positioning <br>2.4 Cessation of uterine stimulation <br>2.5 Intravenous fluid resuscitation <br>2.6 Tocolytics <br>2.7 Correction of maternal hypotension <br>2.8 Maternal oxygen supplementation <br>2.9 Amnioinfusion <br>2.10 Altering pushing efforts in labor <br>2.11 Cord prolapse <br>3. Newborn management <br>3.1 Role of obstetrical anesthesiologist in neonatal resuscitation <br>3.2 Transition from fetal circulation to newborn circulation <br>3.3 Team communication: Maternal team to neonatal team <br>3.4 Thermoregulation <br>3.5 Delayed cord clamping <br>3.6 Initial assessment of the newborn <br>3.7 Neonatal resuscitation <br>3.8 Assessing heart rate <br>3.9 Positive pressure ventilation <br>3.10 Newborn endotracheal intubation equipment <br>3.11 Target oxygenation saturation <br>3.12 Chest compressions <br>3.13 Epinephrine and volume resuscitation <br>3.14 Post resuscitation care <br>4. Neonatal complications <br>4.1 Pneumothorax and airway obstruction <br>5. Special considerations <br>6. Summary <br>References <br><br>58. Diagnosis and treatment of fetal/newborn asphyxia and respiratory failure<br>Miheret Yitayew, Grace Mueller, Whitney Bender, Joseph A. Khoury, Fatoumata Kromah and Nayef Chahin<br><br>1. Anesthetic management in the context of asphyxia and respiratory failure <br>2. Defining birth asphyxia <br>3. Historical evolution of birth asphyxia <br>4. Global impact and challenges <br>5. The fetus&rsquo; cardiovascular response to asphyxia <br>6. Antenatal fetal surveillance for signs of chronic asphyxia <br>7. Intrapartum fetal heart rate assessment <br>8. Ancillary intrapartum fetal well-being assessments <br>9. Physiology of a neonatal hypoxic-ischemic brain injury <br>10. Evaluating for hypoxic ischemic encephalopathy <br>11. Therapeutic hypothermia and prognostication <br>12. Neonatal respiratory failure <br>12.1 Respiratory distress syndrome <br>13. Meconium-stained amniotic fluid and meconium aspiration syndrome <br>14. Congenital diaphragmatic hernia <br>15. Transient tachypnea of the newborn <br>16. Congenital pulmonary airway malformation <br>References <br>Further reading <br><br>59. Retrolental fibroplasia and anesthesia<br>Alan David Kaye, Evan Sinnathamby, Claire Fisher, Hannah Matejowsky, Kristin N. Bembenick, Thomas J. Tran, Shahab Ahmadzadeh and Sahar Shekoohi<br><br>1. Introduction <br>2. Epidemiology <br>3. Risk factors <br>4. Clinical considerations and anesthetic management <br>5. Patient evaluation <br>6. Prevention <br>7. Global impact and challenges <br>8. Diagnostic steps <br>9. Diagnostic modalities <br>10. Treatment <br>11. Advances in treatment <br>12. Clinical studies <br>13. Conclusion <br>References <br><br>60. Long-term effects of anesthetics on the fetal and neonate<br>Farzad Ebrahimi<br><br>1. Introduction <br>2. Is there any empirical evidence demonstrating the teratogenic effects of anesthetic agents administered during the first trimester of pregnancy? <br>2.1 Nitrous oxide <br>2.2 Benzodiazepines <br>2.3 Opioids <br>2.4 Nonsteroidal anti-inflammatory drugs <br>3. Fetal nervous systems development <br>4. Long-term effects of anesthetics administered during the second trimester on the fetus <br>5. Is it safe to administer anesthetics during the third trimester? <br>5.1 Is dexmedetomidine capable of providing brain protection against neuroapoptosis caused by inhalation of gases? <br>6. What are the drawbacks of the prior research? <br>7. Conclusion <br>References <br><br>61. Illustrated ultrasound evaluation of the stomach fasting/nonfasting status<br>Sydney T. Gennaro-Dennis, Emily Johnson, Karlee Mott, Alex Wandler, Shahab Ahmadzadeh, Sahar Shekoohi and Alan David Kaye<br><br>1. Introduction <br>2. Background <br>3. Gastric ultrasound as an effective clinical tool <br>4. Evolving concepts in clinical use of point-of care ultrasounds <br>5. Historical evolution and trends in gastric ultrasound <br>6. Pathophysiology <br>7. Risk factors <br>8. Patient evaluation <br>9. Diagnosis <br>10. Treatment <br>11. Anesthetic management <br>12. Pharmacology <br>13. Clinical issues or considerations <br>14. Prevention and self-care <br>15. Global impact and challenges <br>16. Future directions, novel treatments, or research studies <br>17. Summary and conclusion <br>References <br><br>62. Ultrasound evaluation of the spinal vertebrae<br>Emile Legendre, Grace Wester, Kristen Adams, Alison Hawkins, Varsha Allampalli, Sahar Shekoohi and Alan David Kaye<br><br>1. Key summary points <br>2. Introduction <br>2.1 History <br>2.2 Benefits of neuraxial anesthesia <br>2.3 Traditional landmark approach <br>2.4 History of ultrasound-guided neuraxial anesthesia <br>3. Why use ultrasound? <br>4. Physics and anatomy <br>4.1 Physics of sonography <br>4.2 Gross anatomy of the lumbar spine <br>5. Technical procedure <br>5.1 Sonography of the lumbar spine <br>6. Conclusion <br>Acknowledgment <br>References <br><br>63. Neurological injury after neuraxial anesthesia<br>Ruba Elmaoued and Amy I. Lee<br><br>1. Introduction/background <br>2. Incidence of nerve injuries <br>3. Intrinsic obstetric palsies <br>3.1 Lateral femoral cutaneous nerve <br>3.2 Femoral nerve <br>3.3 Obturator nerve <br>3.4 Lumbosacral plexus <br>3.5 Peroneal nerve <br>3.6 Sciatic nerve <br>3.7 Pudendal nerve <br>4. Anesthesia-related neurologic deficits <br>4.1 Postdural puncture headache <br>4.2 Spinal/epidural hematoma <br>4.3 Infection: epidural abscess and meningitis <br>4.4 Direct trauma <br>4.5 Chemical injury <br>4.6 Arachnoiditis <br>4.7 Transient neurologic syndrome <br>5. Medicolegal implications <br>6. Conclusion <br>References <br><br>Index
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        Pharmacology, Physiology, and Practice in Obstetric Anesthesia