Obstetrical Anesthesia, An Issue of Anesthesiology Clinics

1st Edition, Volume 39-4 - November 16, 2021
Editors: May C. M. Pian-Smith, Rebecca D. Minehart
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 8 4 9 4 2 - 5
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 4 9 4 3 - 2

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Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Foreword
Preface
Obstetrical Hemorrhage
Key points
History
Risk factors and prevention
Diagnosis
Basics of anesthetic management
Tailored anesthetic management
Transfusion management
Systems-based management
Obstetric management
Summary
Clinics care points
Quality Assurance and Quality Improvement in the Labor and Delivery Setting
Key points
Definitions
Background
Goals
Approach for implementing change
Application of quality and safety principles to labor and delivery care
Discussion
Summary
Clinics care points
Emergency Resources in Obstetrics
Key points
Introduction
Discussion
Written/electronic care tools
Emergency obstetric care outside of the obstetric unit
Patient education resources
Summary
Clinics care points
Updates on Simulation in Obstetrical Anesthesiology Through the COVID-19 Pandemic
Key points
Introduction
Simulation-based individual training and assessment
Simulation-based multidisciplinary team training and assessment
Simulation-based assessment of the work environment and practice methods
Simulation in obstetric anesthesiology during the COVID-19 pandemic
The future of simulation in obstetric anesthesiology
Summary
Clinics care points
Escalating Care on Labor and Delivery
Key points
Case
Introduction
Levels of maternal care
Epidemiology of maternal intensive care unit admission
Care of the critically ill parturient
Risk assessments for maternal critical illness
Preventability of maternal critical illness and cognitive biases
Specific bundles for maternal critical illness
Summary
Case continued
Clinics care points
Postpartum Respiratory Depression
Key points
Introduction
Risk factors for postpartum respiratory depression
Summary
Clinics care points
Preeclampsia in 2021—a Perioperative Medical Challenge for the Anesthesiologist
Key points
Introduction
Background
Pathogenesis
Morbidity and mortality
Cardiac function in preeclampsia
Prediction of severity of cardiorespiratory dysfunction
Fluid management
Hemodynamic monitoring in clinical practice
Anesthesia management
Eclampsia
Long-term cardiovascular risk
Summary
Clinics care points
Disclosure
Neuraxial Techniques for Parturients with Thromboprophylaxis or Thrombocytopenia
Key points
Introduction and definitions
Nature of the problem: venous thromboembolism in pregnancy
Nature of the problem: thrombocytopenia in pregnancy
Pharmacologic thromboprophylaxis against venous thromboembolism in pregnancy
Crux of the problem: incidence and risk factors for spinal epidural hematoma in pregnancy
Risk and benefits discussion: avoiding spinal epidural hematoma versus the risk of general anesthesia
Evaluating coagulation status and suitability for neuraxial anesthesia: what to do when faced with thromboprophylaxis and TCP
Recommendations
Summary
Clinics care points
Enhanced Recovery after Surgery: Cesarean Delivery
Key points
Introduction: principles of enhanced recovery after surgery
Why is enhanced recovery after surgery for cesarean delivery (enhanced recovery after cesarean) important?
Enhanced recovery after cesarean pathway elements
Uterotonic administration
Delayed umbilical cord clamping
Approach to multimodal analgesia
Promoting early mobilization
Early urinary catheter removal
Venous thromboembolism prophylaxis
Promoting resting periods
Facilitating breastfeeding
Facilitating early discharge
Outcome studies for ERAC
Summary
Clinics care points
Caring for Parturients with Substance Use Disorders
Key points
Nature of the problem
Introduction: definitions and history
Current evidence
Discussion
Case study
Summary
Clinics care points
Trauma-Informed Care on Labor and Delivery
Key points
Introduction
Discussion
Summary
Clinics care points
Decision Making in Obstetric Anesthesia
Key points
Introduction
Individual cognitive decision-making processes
Influences on individual decision making
Team influences on decision making
Strategies to preserve and enhance decision making in obstetric anesthesia
Future directions
Clinics care points
Point of Care Ultrasound on Labor and Delivery
Key points
Introduction
A brief overview of ultrasound definitions and physics
Cardiac ultrasound
Lung ultrasound
Clinical application of multimodal POCUS in the obstetrical patient
Gastric ultrasound
Performing gastric ultrasound
Neuraxial ultrasound
Performing neuraxial ultrasound
Airway ultrasound
Applications and performing airway ultrasound
Conclusion
Summary
Clinics care points
Ethics in the Labor and Delivery Unit
Key points
Introduction
Making ethically supportable decisions
Ethical theory: principlism
What are the physician’s obligations to a patient?
Who is a patient?
Informed consent on the labor and delivery unit
Shared decision-making on the labor and delivery unit
Summary
Neurocognitive Effects of Fetal Exposure to Anesthesia
Key points
Introduction
Maternal surgery
Fetal interventions or surgery
Clinics care points

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Obstetrical Anesthesia, An Issue of Anesthesiology Clinics

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May C. M. Pian-Smith

Rebecca D. Minehart