Neuraxial analgesia is considered the gold standard in labour analgesia, providing the most effective pain relief during childbirth. Improvements have enhanced the efficacy and safety of epidural analgesia through better…
Parenteral opioids have been used in labour analgesia for many years, but the ideal opioid in this setting is yet to be found. We review the properties of currently used…
Some anesthesiologists perceive obstetric anesthesiology as a “backwater” of anesthesia care. It is simple: place a needle in a laboring woman’s back and inject local anesthetic/opioid solution for labor analgesia…
HELPERR H Call for help E Evaluate for episiotomy L Legs (McRobert’s Maneuver by assistant) P Suprapubic pressure (by assistant) E Enter maneuvers/internal rotation (Rubin’s, Woods Corkscrew) R Remove posterior…
• Pregnancy with multiple fetuses • Fetal macrosomia • Fetal malpresentation • Prior uterine incision or myomectomy • Prolonged labor • Prolonged third stage (>20 min) • Previous postpartum hemorrhage • Placenta previa • Maternal obesity (BMI > 40)…
Fig. 9.1 Ultrasound image of decreased blood flow through right femoral vein DVT in transverse view. Reprinted with permission of the MedStar Georgetown University Hospital & MedStar Washington Hospital Center…
Fig. 5.1 Placenta previa. Ultrasound image showing placenta covering cervical os (arrowheads). Image courtesy of Ian Suchet Management of placenta previa depends on gestational age and stability of the mother….
Gestational period Effects Estimated threshold dosea Before implantation (0–2 weeks after conception) Death of embryo or no consequence (all or none) 50–100 mGy Organogenesis (2–8 weeks after conception) Congenital anomalies…
Gynecologic Genitourinary Gastrointestinal Ovarian torsion Urinary tract infection Appendicitis Ovarian cysts Pyelonephritis Cholelithiasis/cholecystitis Fibroids Urolithiasis Pancreatitis Round ligament pain – Diverticulosis/diverticulitis Vaginal infections – Bowel obstruction Pelvic inflammatory disease –…
Causes of cardiac arrest in pregnancy Obstetric Non-obstetric Iatrogenic Eclampsia Pulmonary embolism General anesthesia-induced Amniotic fluid embolism Sepsis Regional anesthesia-induced Postpartum hemorrhage Trauma Other medications (e.g., magnesium) Antepartum hemorrhage Myocardial…
