Obstetric Anesthesia: A Case-Based and Visual Approach

Description:

With 32 engaging and dramatic cases and 174 colorful, insightful and innovative graphics, this book takes a fresh, creative and highly visual approach to the fundamentals of obstetric anesthesia as well as emerging knowledge and three emerging technologies: 1) pre-procedural ultrasound to facilitate neuraxial block placement, 2) point-of-care transthoracic echocardiography to guide maternal resuscitation, and 3) electrical cardiometry to trend maternal cardiac output and avoid fetal hypoxia.  Besides discussing the threats to fetal oxygenation presented by labor and the avoidance of maternal and fetal complications while providing excellent anesthesia, the book also explores the psychological and behavioral dimensions of obstetric anesthesia practice and promotes the obstetric anesthesiologist as a valued member of the obstetric care team who makes unique, insightful and empathic contributions to the overall excellent care of pregnant patients. Obstetric Anesthesia: A Case-Based and Visual Approach is an indispensable resource for medical students, residents, fellows, anesthesiologists, nurse anesthetists, nurse midwives, and obstetricians.

Table of Contents:

Part I. Pregnancy, Anesthesia and Threats to Fetal Oxygenation

1. Normal Pregnancy, Labor, and Delivery––Without Epidural Analgesia

2. Neuraxial Anesthesia and the Supine Position Cause Non-reassuring Fetal Status

3. Hyperstimulation

4. Scheduled Repeat Cesarean Delivery

Part II. Postpartum Hemorrhage

5. Uterine Atony: The Most Common Cause of Postpartum Hemorrhage

6. Hypovolemic Shock

7. A Traumatic Cesarean Delivery with Consumptive Coagulopathy

8. Trial of Labor After Cesarean Delivery (TOLAC), with Uterine Dehiscence and Emergency Cesarean Delivery Under General Anesthesia

Part III. More Obstetric Crises

9. High Spinal

10. Prolapsed Umbilical Cord

11. A Patient Delivers Vaginally After an Eclamptic Seizure

12. Cesarean Delivery Under General Anesthesia in a Septic Patient

Part IV. More Challenging Cases

13. Morbidly Obese Preeclamptic Patient with Difficult IV Access for Urgent Cesarean Delivery

14. Patient with Known Placenta Previa and Accreta for Elective Cesarean Hysterectomy

15. A Patient with Severe Idiopathic Pulmonary Hypertension Delivers Her Fourth Child

Part V. Successful Neuraxial Anesthesia

16. Fooling Ourselves: Intravenous Fentanyl Creates the Illusion of a Successful Epidural

17. What Not to Do During Uterine Contractions: Three Vignettes with One Simple Lesson

18. A One-Sided Epidural

19. Dosing an Epidural for “Back Labor.”

20. Management of a Patient with an Unsatisfactory Labor Epidural, Now Going for Cesarean Delivery

21. Rescuing a Low Spinal

22. A Failed Epidural Followed by a Failed Spinal (Part 1)

23. A Failed Epidural Followed by a Failed Spinal (Part 2)

24. Labor Epidural for a Patient with Scoliosis

Part VI. Anesthetic Complications

25. Wrong Medication

26. Headache After Dural Puncture with an Epidural Needle

27. Neurological Deficit After Neuraxial Analgesia for Labor and Vaginal Delivery

28. Left Sciatic Neuropathy After Cesarean Delivery in an Obese, Diabetic Patient

29. Vasopressin, Used as a Vasopressor During Cystoscopy, Causes Non-reassuring Fetal Status

30. Emergency Cesarean Delivery After Repair of an Ankle Fracture

31. Another Spinal Mishap

Part VII. Dysfunctional Labor and Uterine Oxygenation: A Theory

32. Cardiac Output-Guided Resuscitation of the Uterus: An Obese Patient Has Dysfunctional Labor Which Resolves with Position Change. Coincidence or Possible Therapy?

Back Matter