Module 8 Obs

Question 1

What are the effects of pregnancy on the lungs

Answer 1

It reduces the FRC by 20%
The O2 consumption increases by 40-60% and in labour can go up to as much as 100%

Question 2

What are the cardiovascular changes that are associated with pregnancy

Answer 2

1. There is a 50% increase in the cardiac output
2. Systemic vascular resistance decreases by 20%
3. Aortocaval compression

Question 3

What are the 3 main haematological changes that occur in pregnancy

Answer 3

1. Blood volume increases
2. Plasma protein conc. decreases
3. Hypercoagulable state

Question 4

How does pregnancy increase the risk of aspiration

Answer 4

1. Increase gastric acid production
2. Delays gastric emptying
3. Decreases the oesophageal sphincter tone
4. Increases intraabominal pressure

Question 5

What are the 3 main options for analgesia in labour

Answer 5

1. Entonox
2. Opiates like morphine
3. Epidural

Question 6

What are the 2 options for C sections anaesthetic

Answer 6

1. Regional
2. General

Question 7

Obstetric complications to a neuraxial 4 [All are related to hypovolemia]

Answer 7

1. Hemorrhage or hypovolemia
2. Major placenta praevia
3. Thrombocytopaneia in preeclampsia
4. CVS comorbidieis

Question 8

What is the dose of oxytocin given to mothers

Answer 8

10 units given slowly over 1-2mins
10-40 units given in the IV 1000ml bag

Question 9

What can be done if the block becomes inadequate

Answer 9

You can give inhaled N2O or fentanyl

Question 10

What is the plan if a patient with an epidural now needs a c section

Answer 10

Convert the epidural into a spinal by going one lower
Switch to general anesthesia

Question 11

What are the 6 indications for GA in obs patient

Answer 11

1. Maternal request
2. Contra to a neuraxial
3. Block failed
4. Severe fetal distress
5. Obstetric haemorrhage
6. HELLP syndrome