Managmnet Of OB Pt w Systemic Pathology

Question 1

Anesthesia ETOH pt

Answer 1

Regional unless drunk
Requirements are less
Check coags: liver dysfunction
Sub clinical L ventricular dysfunction (cardiomyopathy r/t chronic ETOH abuse)
Low sugar, low volume

Question 2

Cocaine fetal effects

Answer 2

• GU tract malformation 14%
• dilated cerebral ventricles
• cardiac anomalies
• high risk SIDS 17%
• respiratory issues

Question 3

N2O, ketamine may exacerbate

Answer 3

Cocaine toxicity

Question 4

Anesthesia for cocaine abuser pt

Answer 4

• Resistant to indirect acting vasopressors: epi/vaso to RX HoTN, depleted catecholamines
• Thrombocytopenia
• Sensitive to depressants,
• Inadequate analgesia

Question 5

Opiates

Answer 5

Increase incidence of pregnancy and c/s fetal distress
Methadone maintenance
EPIDURAL best!

Question 6

Most common medical problems for pregnant women

Answer 6

Gestational DM
DKA more common
Vascular effects are eggravated

Question 7

What happens to insulin sensitivity during labor

Answer 7

Decreased b4 delivery and during labor

Very sensitive after labor - check BS

Question 8

Anesthesia for DM mom

Answer 8

Epidural, OK for GA
Hydration w/NS no dextrose
NO Paracervical block: already has compromise blood flow being DM,

Question 9

Which disease during pregnancy can have stiff jaw

Answer 9

DM

Question 10

What does ACOG recommends and for who

Answer 10

Twins, difficult airway, obesity === EPIDURAL early

Question 11

Fetal ETOH effects

Answer 11

1. Low birthweight
2. Spontaneous abortion, stillbirth
3. FAS 10% will develop 6/10,000

3 drinks/day