M&M: Maternal & Fetal Physiology

Question 1

Pregnancy does not increase susceptibility to LA toxicity. True or false?

Answer 1

True.

Question 2

What causes engorgement of the epidural venous plexus that in turn increases epidural blood volume?

Answer 2

obstruction of the IVC

Question 3

What are the effects of the obstructed vena cava? (3)

Answer 3

enhanced spread of LA cephalad due to

• decreased spinal CSF
• decreased epidural space

increased epidural space pressure–increases risk of dural puncture

Note: Valsava has the same effect.