OB part I
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Respiratory changes during pregnancy?
- FRC decrease
- Min Ventilation and RR increase
_________ ___________, aka spuine hypotensive syndrome, causes aortoilliac compression in ___ of women, and vena cava compression in ____. solution: _ _______ _____________.
- aortocaval compression
- L uterine displacement
T or F, nasal instrumentation should be avoided in pregnant women and airway edema may will lead to a less than optimal laryngeal view?
# times pt has been pregnant
Name the four parts of Parity:
- full term births
- pre-term births
- living children
Pregnancy causes an increase in total blood volume by ___, heart rate by ___, SV by ___ and CO by ____. A ________ is seen in peripheral vascular resistance.
how much can CO increase just after delivery?
GI changes during pregnancy (6)
- all labor treated as full stomach
- stomach displacement by uterus causes reflux
- gastrin from placenta makes stomach more acidic
- All women undergiong surgery should have antacid (non particulate)
- use a cuff OETT slightly smaller than normal
- Aspiration is major risk for this population
Describe relative anemia seen during pregnancy. What is a normal pregant H/H? what other blood component is decreased with pregnancy?
- plasma and total blood volume increase about 40%, red cell mass only increases about 20%.
- hgb 11-12, Hct 35%
- platelet count
pregnancy causes a _______________ state, Why? Creates higher risk for what two things?
- increased coag factors and anticlotting factors.
- DIC, DVT's
How much MVO2 increase with pregnancy?
pa___ is decreased with pregnancy.
What is the reason for gestational diabetes, and worsened diabetes?
placental hormones cause tendency for hyperglycemia.
What leads to changes in response to drugs during pregnancy?
- decreased plasma cholinesterase, plasma protein concentration, MAC
- increase neuraxial spread of LA's
When is MAC decreased with pregnancy?
safest, most effective intervention for labor pain?
stages of labor:
- 1- dilation of cervix to 10 cm
- 2- fetus moving from cervix, out
- 3- placental delivery
- 4- time until physiologically normal (2-6 weeks)
What three things are needed before performing an epidural?
when performing epidural, what should be noted about ligaments in a gravid pt?
What is a normal fetal heart rate?
When fetal tracings be evaluated?
- decelerations in relation to contractions
- accelerations- good if related to stimulus. bad if constant tachy
- variability- fine and coarse
early decelerations are related to....?
head compression as fetus moves toward delivery
variable decelerations are related to....?
uterine cord prolapse
Late decelerations are related to....?
fetal asphyxia following contractions
What level block is needed for a c-section?
t4, more dense than for labor alone
mortality rate in c-section __ times greater with GA than with _________.
what induction drugs are not transferred to the fetus, in the case of GA?
spinal anesthesia contraindicated with what disease?
volatile anesthetics contribute to what?
What would you like to do?
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