Obstetric Anesthesia Flashcards
Maternal weight gain is how many percent or how much kg?
17%
12 kg
The expected weight increase in the 1st trimester is?
How about each in the last two trimesters?
1-2 kg
5-6 kg
The hypertrophy results from?
Increase in size of cardiac myocytes rather than the size
How long will the hemodynamic changes return to prepregnancy values?
24 weeks
Compression of the IVC occur as early as?
13 to 16 weeks
During uterine contractions 300 to 500 mL of blood is displaced from the intervillous space through the relatively unimpeded ovarian venous outflow system. This term is referred to as?
Autotransfusion
Heart rate returns to prepregnancy levels after how long?
2 weeks postpartum
Capillary engorgement of the larynx and mucosa begins as early as?
1st trimester
FRC begins to decrease by what AOG?
5th AOG
Caused by elevation of the diaphragm
Maternal plasma volume increases as early as how many weeks AOG?
6
Until it reaches by 50% by 34 weeks
Clotting factors that are increased during pregnancy (6)
1 (fibrinogen) 7 (proconvertin) 8 (antihemophilic factor) 9 (Christmas factor) 10 (Stuart-power factor) 12 (hageman factor)
Unchanged factor concentrations (2)
2
5
Decreased factor concentrations (2)
11
13
The hgb concentration decrease during the first 3 postpartum days and increase during the next __ days?
3
Albumin returns to normal after how many weeks postpartum?
6
The coagulation profile returns to normal for how many weeks postpartum?
2 weeks
Stomach is rotated to the?
45 degrees to the R
Risk factors for GERD (3)
- Gestational age
- Prepregnancy GERD
- Multiparity
Prepregnancy BMI, gravidity, do not correlate
Maternal age has inverse correlation
Read
Gastric emptying is not changed during pregnancy
But esophageal peristalsis and intestinal transit are slowed
The GFR does not return to prepregnancy levels by how long postpartum?
3 months
What are among the earliest and most dramatic changes in pregnancy?
Renal hemodynamics
The protein to creatinine ratio of what value has been estimated as indicating significant proteinuria
0.18
Endocrine
Increase TBG, T3 & T4
Free T3 & free T4 is not increased
TSH decreases but returns to nonpregnant level
Fetal thyroid gland start to produce thyroid hormones until end of 1st trimester
Corticosteroid binding globulin doubles during pregnancy
Betamethasone clearance is greater since the drug is metabolized by placental enzymes
A paresthesia or sensory loss on the anterolateral thigh
Meralgia paresthetica
Cerebral flow increases in pregnancy due to? (2)
- Inc cerebrovascular resistance
2. Inc internal carotid artery diameter
Other 2 cerebral changes
- Inc BBB permeability inc hydrostatic P
2. Inc capillary permeability
Vertebral column changes
- Epidural fat & veins enlarge
2. Spinal csf vol reduced
Pregnant and postpartum exhibit enhanced sensitivity to what muscle relaxants? (2)
- Vecuronium
2. Rocuronium
Onset and duration of this drug is shorter in women immediately after delivery?
Cisatracurium
Magnesium sulfate side effects
10 meq/L?
15 meq/L
25 meq/L
Loss of DTR
Respiratory paralysis
Cardiac arrest
The oculocardiac reflex is triggered by pressure on the globe and by traction on the extraocular muscles as well as on the conjunctiva or on the orbital structures. This reflex, whose afferent limb is _______ and efferent limb is _______ .
Trigeminal
Vagal
Walls of orbit are composed of these Bones (7)
- Frontal
- Zygomatic
- Greater wing of sphenoid
- Maxilla
- Palatine
- Lacrimal
- Ethmoid
3 layers of the eye
Sclera
Uveal tract
Retina
What composes the uveal tract?
- Iris
- Ciliary body
- Choroid
The lacrimal duct drains to which turbinate?
Below the inferior turbinate
Average production of aqueous humor?
2 uL/min
IOP normal range
10 to 20 mmHg
Straining, vomiting or coughing increases IOP to what value?
40 mmHg
How much increase in IOP does succinylcholine make?
9 mmHg within 1 to 4 minutes