Term
| What % of cesarean deliveries result in VAE and why do they think this happens? |
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Definition
52%
They think that the separation of the placenta creates an ingress of air into the uterus. Traction and flopping the uterus on top of mom's belly increase the incidence. |
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Term
| What is the most common and serious symptom of VAE w/ C-sections? |
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Definition
| abrupt reductions in ETCO2 |
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Term
| What happens if there's a VAE in the coronary system? Neurovascular system? |
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Definition
VAE in coronary circulation leads to arrhythmias. It leads to seizures, unconsciousness, and blindness in cerebral circulation.
**these are dependent on how much air is entrained** |
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Term
| What % of thromboembolism is found in the parturient? |
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Definition
0.5%
PE= 24% w/ 15% resulting in death
*it is rare, but the risk continues through post delivery phase* |
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Term
| Pregnancy is called a diabetogenic condition. What are some fetal abnormalities w/ this? |
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Definition
| macrosomia, polyhydraminos, IUGR and retarded pulmonary maturation |
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Term
| The chronic over supply of glucose induces fetal islet cell hypertrophy and hyperinsulinemia. What happens when the cord is cut? |
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Definition
| Hypoglycemia (<30mg/dL) occurs in 40% of the infiants |
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Term
| What is the most serious fetal risk during non-obstetric surgeries? |
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Definition
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Term
| What are two anesthetic agents we are most concerned w/ that may be teratogenic? |
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Definition
Nitrous - esp. in 1st trimester (remember Nagelhout?)
Benzos - in 1st trimester
*per Gayle, Ketamine is also implicated. |
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Term
| What can happen if you give nitrous or benzos to a preggars in the 1st trimester? |
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Definition
-Increased risk of cleft lip and palate
-neurogenerative apoptosis w/ persistent memory and learning impaiment |
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Term
| What is the time range Gayle said would be appropriate to perform RSI during pregnancy? |
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Definition
12 wks of gestation --> 12 weeks post-op/birth
**delayed gastric emptying can occur between 8-14 wks (we use 12wks as a cut-off) |
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