Obstetric anaesthesia Flashcards
(29 cards)
What is pre-eclampsia?
The onset of hypertension and proteinuria after 20 weeks of pregnancy.
What is proteinuria?
High levels of protein in urine.
What can happen in severe cases of pre-eclampsia?
Haemolysis, thrombocytopenia, impaired liver and kidney function, oedema, visual disturbances and pulmonary oedema.
What is haemolysis?
The destruction of red blood cells.
What is thrombocytopenia?
Low platelet count.
What is pulmonary oedema?
Excessive fluid accumulation in the tissue or air spaces of the lungs.
What if conservative management with oral anti-hypertensives is unsuccessful with pre-eclampsia?
Patients will require IV drugs and infusions, invasive blood pressure monitoring and surgical delivery as the definitive treatment.
What must be checked before epidural?
A name-band, working IV access and blood pressure monitoring available in the room.
What must be in patient room before epidural?
An ambu-bag and working suction.
Can a patient take entonox during epidural?
If already prescribed and in use, then yes.
What is a complication of an epidural?
Accidental dural puncture.
What can an accidental dural puncture cause?
A post-dural puncture headache in the days after delivery.
If conservative management fails, what treatment is there for a post-dural headache?
Blood patch procedure.
What is oxytocin?
A hormone that acts on organs in the body (including the breast and uterus) and as a chemical messenger in the brain, controlling key aspects of the reproductive system, including childbirth and lactation.
What is the administration of oxytocin routine in?
In patients undergoing caesarean sections.
What does oxytocin promote?
Contraction of the uterine smooth muscle.
What can oxytocin reduce through helping with contraction?
Blood loss at the place of placental detachment – postpartum haemorrhage.
When would an anaesthetist choose NOT to top up an existing epidural for surgery?
– Problems achieving good pain relief with current epidural.
– Top-up dose likely to exceed toxicity threshold.
What is twin-to-twin transfusion syndrome (TTTS)?
An abnormal connection of blood vessels in the placenta, resulting in an imbalanced blood flow between identical twins in one placenta.
How is TTTS treated?
Laser foetoscopy.
What is a Category 1 caesarean?
Immediate threat to life of mother or foetus.
What is a Category 2 caesarean?
No immediate threat to life but definite compromise requiring surgery.
What is a Category 3 caesarean?
Requires early delivery, no maternal or foetal concern.
What is a Category 4 caesarean?
Delivery to suit needs of department or woman.
