Analgesia, Anaesthesia and Pregnancy: A Practical Guide

by Edited by Steve Yentis , Anne May , Surbhi Malhotra

• ISBN13: 9780521694742
• ISBN10: 0521694744
• Edition: 2nd
• Format: Paperback
• Copyright: 2007-06-11
• Publisher: Cambridge University Press

Summary

A thoroughly updated edition of this well-established practical guide to obstetric analgesia and anaesthesia. All aspects of obstetric medicine relevant to the anaesthetist are covered, from conception, throughout pregnancy, to after birth care. The emphasis is on pre-empting problems and maximising quality of care. The authors have identified over 150 potential complications each covered in two sections: issues raised and management options, with key points extracted into boxes for quick reference. A section on organisational aspects such as record keeping, training, protocols and guidelines makes this an important resource for any labour ward or hospital dealing with pregnant women. Presented in a clear, structured format, this book will be invaluable to trainee anaesthetists at all levels and to experienced anaesthetists who encounter obstetric patients. Obstetricians, neonatologists, midwives, nurses and operating department practitioners wishing to extend or update their knowledge will also find it highly beneficial.

Table of Contents

List of contributors	p. xiii
Preface	p. xv
Preconception and Conception
Assisted conception	p. 1
Ovarian hyperstimulation syndrome	p. 3
Anaesthesia before conception or confirmation of pregnancy	p. 5
Pregnancy
Procedures in early/mid-pregnancy	p. 7
Cervical suture (cerclage)	p. 7
Ectopic pregnancy	p. 8
Evacuation of retained products of conception	p. 10
Incidental surgery in the pregnant patient	p. 12
Intrauterine surgery	p. 14
Termination of pregnancy	p. 16
Normal pregnancy and delivery	p. 18
Anatomy of the spine and peripheral nerves	p. 18
Physiology of pregnancy	p. 27
Aortocaval compression	p. 31
Normal labour	p. 33
Gastric function and feeding in labour	p. 35
Drugs and pregnancy	p. 37
Placental transfer of drugs	p. 39
Prescription and administration of drugs by midwives	p. 42
Local anaesthetics	p. 44
Antenatal fetal monitoring	p. 46
Charting of labour	p. 48
Intrapartum fetal monitoring	p. 51
Pain of labour	p. 54
Epidural analgesia for labour	p. 56
Epidural test doses	p. 60
Combined spinal-epidural analgesia and anaesthesia	p. 63
Spinal analgesia	p. 67
Caudal analgesia	p. 69
Spinal and epidural opioids	p. 69
Inhalational analgesic drugs	p. 72
Systemic analgesic drugs	p. 74
Non-pharmacological analgesia	p. 77
Operative delivery and third stage	p. 80
Instrumental delivery	p. 80
Caesarean section	p. 82
Epidural anaesthesia for Caesarean section	p. 86
Spinal anaesthesia for Caesarean section	p. 90
General anaesthesia for Caesarean section	p. 94
Cricoid pressure	p. 98
Failed and difficult intubation	p. 99
Awake intubation	p. 103
Post-Caesarean section analgesia	p. 104
Removal of retained placenta	p. 107
Anaesthetic complications	p. 110
Bloody tap	p. 110
Dural puncture	p. 111
Postdural puncture headache	p. 114
Epidural blood patch	p. 116
Extensive regional blocks	p. 118
Inadequate regional analgesia in labour	p. 122
Backache	p. 124
Horner's syndrome and cranial nerve palsy	p. 126
Peripheral nerve lesions following regional anaesthesia	p. 128
Spinal cord lesions following regional anaesthesia	p. 130
Arachnoiditis	p. 132
Cauda equina syndrome	p. 134
Opioid-induced pruritus	p. 135
Shivering	p. 136
Aspiration of gastric contents	p. 138
Awareness	p. 141
Air embolism	p. 144
Problems confined to obstetrics	p. 147
Induction and augmentation of labour	p. 147
Oxytocic and tocolytic drugs	p. 149
Premature labour, delivery and rupture of membranes	p. 152
Malpresentations and malpositions	p. 154
External cephalic version	p. 156
Multiple pregnancy	p. 157
Trial of scar	p. 159
Under-age pregnancy and advanced maternal age	p. 161
Placenta praevia	p. 162
Placental abruption	p. 165
Prolapsed cord	p. 166
Fetal distress	p. 168
Intrauterine death	p. 170
Uterine inversion	p. 172
Major obstetric haemorrhage	p. 173
Postpartum haemorrhage	p. 176
Collapse on labour ward	p. 179
Maternal cardiopulmonary resuscitation	p. 180
Amniotic fluid embolism	p. 182
Cholestasis of pregnancy (obstetric cholestasis)	p. 183
Acute fatty liver of pregnancy	p. 185
HELLP syndrome	p. 187
Hypertension, pre-eclampsia and eclampsia	p. 189
Magnesium sulphate	p. 196
Hyperemesis gravidarum	p. 198
Maternal mortality	p. 201
Problems not confined to obstetrics	p. 204
Allergic reactions	p. 204
Cardiovascular disease	p. 206
Arrhythmias	p. 210
Pulmonary oedema	p. 212
Cardiomyopathy	p. 213
Coarctation of the aorta	p. 216
Prosthetic heart valves	p. 218
Congenital heart disease	p. 220
Pulmonary hypertension and Eisenmenger's syndrome	p. 223
Ischaemic heart disease	p. 226
Endocrine disease	p. 228
Diabetes mellitus	p. 229
Anaemia and polycythaemia	p. 232
Deep-vein thrombosis and pulmonary embolism	p. 234
Thrombophilia	p. 237
Coagulopathy	p. 240
Von Willebrand's disease and haemophilia	p. 241
Disseminated intravascular coagulation	p. 243
Thrombocytopenia	p. 245
Lymphoma and leukaemia	p. 248
Haemoglobinopathies	p. 249
Rheumatoid arthritis	p. 252
Cervical spine disorders	p. 254
Kyphoscoliosis	p. 255
Low back pain	p. 257
Neurological disease	p. 260
Meningitis	p. 262
Acute post-infective peripheral neuropathy (Guillain-Barre syndrome)	p. 264
Past history of neurological trauma	p. 265
Benign intracranial hypertension	p. 267
Intracranial tumour	p. 268
Cerebrovascular accident	p. 270
Epilepsy	p. 272
Migraine	p. 274
Multiple sclerosis	p. 275
Myasthenia gravis	p. 276
Spina bifida	p. 278
Convulsions	p. 280
Respiratory disease	p. 282
Asthma	p. 283
Cystic fibrosis	p. 285
Pulmonary fibrosis	p. 287
Sarcoidosis	p. 287
Acute lung injury (acute respiratory distress syndrome)	p. 289
Psychiatric disease	p. 290
Obesity	p. 293
Pyrexia during labour	p. 295
Connective tissue disorders	p. 297
Renal failure	p. 300
Hepatitis	p. 302
Herpes simplex infection	p. 304
HIV infection	p. 305
Sepsis	p. 308
Steroid therapy	p. 310
Substance abuse	p. 312
Trauma in pregnancy	p. 315
Malignant disease	p. 317
Transplantation	p. 319
Intensive care in pregnancy	p. 321
Invasive monitoring	p. 323
The neonate	p. 326
Neonatal assessment	p. 326
Neonatal physiology and pharmacology	p. 329
Neonatal resuscitation	p. 331
Perinatal mortality	p. 334
Puerperium and After
Drugs and breastfeeding	p. 337
Follow-up	p. 339
Maternal satisfaction	p. 341
Organisational Aspects
Antenatal education	p. 345
Audit	p. 347
Labour ward organisation	p. 349
Midwifery training	p. 351
Consent	p. 352
Medicolegal aspects	p. 355
Record keeping	p. 357
Minimum standards, guidelines and protocols	p. 359
Risk management	p. 362
Post-crisis management	p. 364
Research on labour ward	p. 366
Obstetric anaesthetic organisations	p. 368
Vital statistics	p. 370
Historical aspects of obstetric analgesia and anaesthesia	p. 371
Index	p. 375
Table of Contents provided by Ingram. All Rights Reserved.