OB (10/10) Flashcards
complications of neuraxial analgesia
- inadequate
- unintentional dural puncture
- Respiratory depression
- intravascular injeciton
- high spinal
- extensive motor block
- prolonged block
- sensory changes
- back pain
- pelvic floor injury
epidural analgesia can prolong which stage of labor
2nd stage (pushing stage)
you performed a combined spinal epidural, you dosed the spinal when you placed but did not use the epidural. 1 hour later you come back to start the epidural, what is the first thing you do?
do another test dose
common dose of bupivicaine in epidural
0.0625-0.125 %
dose of bupivicaine in spinal
1.25-2.5 mg
dose of ropiv in epidural
0.08-0.2%
dose of ropiv in spinal
2.5-4.5 mg
dose of levobupiv in epidural
0.0625 - 0.125%
dose of levobupiv in spinal
2.5-4.5 mg
dose of lido in epidural
0.75-1%
dose of fentanyl in epidural
50-100 mcg
dose of fentanyl in spinal
15-25 mcg
dose of sufenta in epidural
5-10 mcg
dose of sufenta in spinal
1.5-5 mcg
dose of morphine in spinal
0.125-0.25 mg
common indications for C/S
- dystocia
- malpresentation
- non-reassuring fetus
- previous C/S
- maternal request
- OB discretion
- previa
- placental or uterine abruption
- active gential herpes
- multiple gestation
- prolapsed umbilical cord
- deteriorating maternal condition
TOLAC
- trial of labor after C-section
- someone trying to have vaginal delivery after C/S
VBAC
vaginal birth after C/S
ECV
external cephalic version (baby is breech)
C/S complications
- hemorrhage
- infections
- thromboemboli
- ureteral/bladder injury
- abdominal pain
- future uterine rupture
- death
_______________ C/S has a greater risk of maternal morbidity and severe maternal mortality rates
non-elective (emergent)
what are some ways a C/S can be prevented/avoided
- adequate labor epidural
- external cephalic version (rotating the bby)
- intrauterine resuscitation (optimize maternal position, O2, IVF/vasopressors, D/C pitocin, consider tocolytic)
- TLC from CRNA