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What is the chance of a unrecognized pregnancy in women presenting for ambulatory surgery?
Can pregnancy result in cancellation of surgery?
Who should receive a pregnancy test?
and female btw 15-50.
Pregnancy test types:
- URINE: 97% accurate
- BLOOD: quantitative blood test measures exact amount of HCG in blood.
- qualitative blood test gives yes or no to pregnancy
Surgery during pregnancy only conducted when _________ _________ for the wellbeing of the ______, _______, or both.
- absolutely necessary
____ general anesthetic _______ placenta.
Regional anesthesia is ________, when practical.
0.75-2% of women require ____ -_______ surgery each year.
Where should surgery be performed on pregnant women? Who should be available during surgery for the mother and baby(2)?
- an institution with neonatal and ped services
- surgeon with c-section delivery privelages AND someone with ability to interpret fetal heart rate patterns.
Pre-op eval and pregnancy:
- Understand risks by trimester
- know which fetal assesments have been performed to date
- Has primary service Ob/Gyn been consulted?
Decreased HR is seen in what trimester?
what happens to peripheral resistance in pregnancy?
FRC is __________ with pregnancy.
Vt is ______ with pregnancy
REsp ________ may be seen during pregnancy
GI changes during pregnancy (2)
- Decreased motility
- Decreased esoph sphincter tone
What occurs with the Musculoskeletal system during pregnancy?
increased ligament taxity
Risk to pregnant pt:
- difficult intubation
- hyoptension- aortocaval compression
- risk of aspiration
Aortocaval compression can be avoided by using _____ _______ _________, and is seen after _____ weeks.
- left uterine displacement
Fetal monitoring may be used when:
- fetus viable
- physically possible
- healthcare provider w obstetric surgical privelages, willing to intervene during procedure for fetal indications
- women has given consent for emergent c-section
- nature of surgery allows for safe interruption or alteration of procedure to provide access to perform emergency surgery