Pregnancy and C Section Flashcards
How much does Cardiac output increase during pregnancy?
30-50%
What happens during pregnancy for the cardiovascular system?
Plasma volume increases RBC increase Decreased PCV Decreased Cardiac reserve Aortacaval compression
Aortacaval compression
when a pregnant animal is put on their back the weight of the fetus and uterus presses on the great vessels causing decreased venous return
What happens to the Respiratory system of a pregnant animal?
Increased O2 consumption Decreased PaCO2 (hyperventiation) Decreased functional residual capacity Increased abdominal volume Decreased pulmonary resistance
How does progesterone affect the pulmonary resistance?
relaxation of bronchial smooth muscles
What happens to the GI system during pregnancy?
Delayed gastric emptying
Decreased gastric motility
Increased progesterone
Increased gastric acidity
Decreased lower esophageal sphincter tone
Increased risk of regurgitation/aspiration
What happens to the Renal system during pregnancy?
Glomerular filtration rate increases in parallel with cardiac output
Decreased BUN and creat
No change in electrolytes
What changes pharmacologically with pregnant animals?
Decreased MAC
Increased sensitivity to local anesthetics
What is the ideal drug protocol for pregnant animals?
Maximize O2 delivery to fetus
Maintain CO and oxygenation
Avoid uterine contraction or uterine vasoconstriction
Minimize drug effects on fetus
What drug causes fetal depression?
Benzodiazepines
What drugs cause decreased cardiac output in a pregnant animal?
Alpha-2 agonists
What drug is long acting, not reversible, and fetal depression in pregnant animals?
Acepromazine
What do alpha 2 agonists cause in large animals?
Increased uterine pressure
Decreased O2 delivery to fetus
What is the difference between detomidine and xylazine in pregnant animals?
Detomidine may cause less increase in uterine tone compared to xylazine
What does xylazine cause in ruminants?
abortion
What drug is used in induction of small pregnant animals?
Propofol
What induction agent can be used safely in large animal but is controversial in small animal pregnancy?
Ketamine
What does pregnancy do to dose requirement of Local anesthetics?
Decreases dose requirement
What do you do for anesthesia during pregnancy?
Maintain fetal O2 delivery by maintaining maternal BP and oxygenation
What do you want to avoid with anesthesia during pregnancy?
Uterine contraction
Uterine vasoconstriction
When is Anesthesia required?
Controlled vaginal delivery
C-section
Small Animal Pregnant Anesthesia Technique
Pre-oxygenate 5 mins \+/- short acting opioid Propofol or alfaxalone induction Rapid control of airway Iso/Sevo/Des in O2 maintenance Consider Local anesthesia in conjunction with GA Careful positioning
What are the complications associated with Epidurals in pregnant animals?
INcreased volume of epidural blood vessels
Increased epidural fat
Increase the cranial spread of drug
What should you do for epidural drug volume in a pregnant animal?
1/3 volume decrease
Small Animal neonatal care
Clear oropharynx Clamp and cut umbilicus Towel dry Reverse opioid sublingually Heat support \+/- O2 support
What does Large animal GA require?
High peak inspiratory pressures or positive end-expiratory pressure
