Managmnet Of OB Pt w Systemic Pathology Flashcards
1
Q
Anesthesia ETOH pt
A
Regional unless drunk Requirements are less Check coags: liver dysfunction Sub clinical L ventricular dysfunction (cardiomyopathy r/t chronic ETOH abuse) Low sugar, low volume
2
Q
Cocaine fetal effects
A
- GU tract malformation 14%
- dilated cerebral ventricles
- cardiac anomalies
- high risk SIDS 17%
- respiratory issues
3
Q
N2O, ketamine may exacerbate
A
Cocaine toxicity
4
Q
Anesthesia for cocaine abuser pt
A
- Resistant to indirect acting vasopressors: epi/vaso to RX HoTN, depleted catecholamines
- Thrombocytopenia
- Sensitive to depressants,
- Inadequate analgesia
5
Q
Opiates
A
Increase incidence of pregnancy and c/s fetal distress
Methadone maintenance
EPIDURAL best!
6
Q
Most common medical problems for pregnant women
A
Gestational DM
DKA more common
Vascular effects are eggravated
7
Q
What happens to insulin sensitivity during labor
A
Decreased b4 delivery and during labor
Very sensitive after labor - check BS
8
Q
Anesthesia for DM mom
A
Epidural, OK for GA
Hydration w/NS no dextrose
NO Paracervical block: already has compromise blood flow being DM,
9
Q
Which disease during pregnancy can have stiff jaw
A
DM
10
Q
What does ACOG recommends and for who
A
Twins, difficult airway, obesity === EPIDURAL early
11
Q
Fetal ETOH effects
A
- Low birthweight
- Spontaneous abortion, stillbirth
- FAS 10% will develop 6/10,000
3 drinks/day
