By David H. Chestnut MD, Cynthia A Wong MD, Lawrence C Tsen MD, Warwick D Ngan Kee, Yaakov Beilin MD, Jill Mhyre MD
"...a accomplished and modern, sleek reference text." by means of British magazine of Anaesthesia, may perhaps 2015
"Chestnut and his seventy nine professional individuals have once more published a present consultant to obstetric anesthesia that proves helpful to either junior inexperienced persons and subspecialty providers." by way of Canadian magazine of Anesthesia, Apr 2015
- Emphasizes the remedy of the fetus and the mummy as separate sufferers with special must make sure the software of recent rules of care.
- Delivers contributions from many leaders within the fields of obstetric anesthesia and maternal-fetal drugs from around the world.
- Offers plentiful figures, tables, and packing containers that illustrate the step by step administration of an entire variety of scientific situations.
- Presents key aspect summaries in every one bankruptcy for fast, handy reference.
- Stay present at the most modern developments and developments with sweeping updates and new chapters on themes comparable to sufferer safeguard and group process, transthoracic echocardiography and noninvasive dimension of cardiac output in obstetric sufferers, psychiatric issues while pregnant, neurologic accidents, and more.
- Prevent and plan for strength issues associated with the advancing age of pregnant ladies. an in depth, state-of-the artwork dialogue of "critical care of obstetric sufferers" equips you to handle any specified issues for this expanding section.
- Know precisely how one can continue. An abundance of tables and bins illustrate the step-by-step administration of a whole diversity of scientific scenarios.
- Choose the simplest medicinal drugs to be had while adhering to the latest directions for obstetric anesthesia.
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Additional resources for Chestnut's Obstetric Anesthesia: Principles and Practice
Although only 4% of nonpregnant women snore, as many as 23% of pregnant women snore by the third trimester. Snoring is more common in women with preeclampsia. Pregnancy is associated with transient restless leg syndrome, a disorder in which the patient experiences the need to move her legs. 219 Central Nervous System Cerebral blood flow increases in pregnancy. 8 mL/min/100 g during the third trimester (Figure 2-11). The increase was secondary to a decrease in cerebrovascular resistance and an increase in internal carotid artery diameter.
Pregnant patients show decreased local anesthetic dose requirement in the first trimester. 256 Pregnant women exhibit a more rapid onset and a longer duration of spinal anesthesia than nonpregnant women who receive the same dose of local anesthetic. 263 Spinal dose requirements change rapidly in the postpartum period, with segmental dose requirements returning to those of nonpregnant women within 24 to 48 hours264 as spinal CSF volume expands with the relief of vena caval compression. 265,266 Pregnancy does not enhance the susceptibility of ewes to the neurotoxicity of lidocaine or to the cardiac toxicity of bupivacaine (see Chapter 13).
The fetal thyroid gland cannot produce thyroid hormone until the end of the first trimester and relies solely on maternal T4 production during this critical time of development and organogenesis. 200 This finding is explained by the greater glucose demand of the fetus and the placenta. The relative hypoglycemic state results in fasting hypoinsulinemia. Pregnant women also exhibit exaggerated starvation ketosis. 201 The blood glucose levels after a carbohydrate load are greater in pregnant women than in nonpregnant women, despite a hyperinsulinemic response.