Obstetrics Flashcards
A patient requires an emergency cesarean section. Which of the following is the MOST likely cause for rapid arterial oxygen desaturation during intubation?
a. decreased expiratory reserve volume
b. increased inspiratory reserve capacity
c. increased residual volume
d. decreased vital capacity
a. decreased expiratory reserve volume
The parturient is at higher risk of these three things related to the airway:
difficult mask ventilation
difficult laryngoscopy
difficult intubation
Factors that make airway management more complicated in the parturient include
increased Mallampatti score
upper airway vascular engorgement
narrowing of the glottic opening
______ these factors hasten the onset of hypoxemia during apnea for the parturient.
increased oxygen consumption paired with a decreased FRC
__________ increases minute ventilation up to 50% leading to the mother developing a mild compensated respiratory alkalosis.
Progesterone
_______ falls below _________, which causes airway closure during tidal breathing.
Functional reserve capacity falls below closing capacity.
Upper airway swelling in the parturient is te result of
increased progesterone, estrogen, and relaxin causing vascular engorgement and hyperemia
& increased extracellular volume
Since the glottic opening is narrowed______ should be used.
a downsized endotracheal tube
Airway edema is worsened by
preeclampsia, tocolytics, and prolonged Trendelenburg position
What type of laryngoscope handle is recommended for large breasted women?
a short-handled laryngoscope (Datta handle)
Why should nasal intubation be avoided in full term mothers?
the tissue in the nasopharynx is particularly friable because of hormonal changes and local edema
Which hemodynamic variables increase during pregnancy?
a. heart rate
b. stroke volume
c. systemic vascular resistance
d. pulmonary artery occlusion pressure
A & B
SV is increased as a function of increased intravascular volume while heart rate is increased to satisfy higher metabolic demand
_________ increases throughout pregnancy to support the growing fetus.
Maternal oxygen consumption
What hemodynamic factors remain stable throughout pregnancy?
MAP & SBP
What hemodynamic variables decrease during pregnancy?
DBP, SVR, and PVR
Describe how dilutional anemia results in the pregnant patient.
plasma volume expansion outpaces new RBC production
Pregnancy produces a ___________ that predisposes mothers to DVT
hypercoagulable state
In the supine position, the gravid uterus compresses both the
vena cava and aorta leading to aortocaval compression