.
Pregnancy
Patient (condition)
 
Aliases:
Pregnancy
Parturient
Gravid

Topic aliases are alternate phrasings for a particular topic.


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The many ways obesity complicates pregnancy

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Oct 24, 2015
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In the event of cardiac arrest, perimortem cesarian-section should be commenced within 10min of circulatory collapse. Discussion and preparation for this should be commenced within 4 minutes as it is often difficult to find a scalpel in an emergency. #ref

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Mar 15, 2013
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Antacid prophylaxis for patients at risk of pulmonary aspiration undergoing general anesthesia. This includes sodium citrate immediately prior to anesthesia, and a proton pump-inhibitor 1-5hrs before. refl.in/ew

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Elective surgery should not be undertaken during pregnancy. Where possible, delay surgery until the postnatal period or alternatively into 2nd trimester, when teratogenic risks to the fetus are reduced. refl.in/et

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Aug 20, 2011
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Fetal monitoring may be used to detect fetal distress and allow maternal physiology to be manipulated to optimise uterine blood flow. The value of this, however, is yet to be proven.

Discuss this with the patient's obstetrician.

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Position patient with a lateral tilt to reduce uterine aortocaval compression from 18 weeks onwards. Ensure more than 15 degrees, up to full lateral tilt if ongoing hypotension

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Analgese well to avoid sympathetic stimulation that may reduce placental blood flow.

Adequate local anaesthesia where possible.

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Mar 16, 2013
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At elevated risk of gastro-oesophageal reflux due to the physiological changes during pregnancy. Consider patients to be at increased risk of aspiration from the 18th-20th week onwards, and manage airway accordingly with rapid sequence-induction and intubation. refl.in/eu refl.in/es

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Minimise risk of fetal asphyxia by paying close to attention to factors that contribute to fetal oxygen delivery. Maintain normal arterial oxygen tension, cardiac output, hemaglobin, acid-base status, maternal blood pressure and uterine blood flow. refl.in/ev

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Aug 20, 2011
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Avoid NSAIDS in third trimester -> possibility of premature closure of the fetal ductus arteriosus/DA

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Aug 20, 2011
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Classification of drug safety in pregnancy. See refl.in/7m and simp.ly/publish/KZ2Rgz

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Jun 06, 2011
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Anticholinesterase inhibitors are highly ionised therefore do not readily cross the placenta, and are safe to use. #ref

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Consider avoiding N2O in the 1st trimester. Theoretical effect on fetus from inactivation of methionine synthetase. #ref

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If an anticholinergic is required perioperatively, glycopyrrolate is less likely than atropine to cross the placenta and hence less likely to result in fetal tachycardia. refl.in/er

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Aug 20, 2011
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Ketamine should be avoided in early pregnancy as it increases intrauterine pressure, resulting in fetal asphyxia. This increase in intrauterine pressure is not apparent in the third trimester. #oha

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Jun 04, 2011
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Muscle relaxants: because these agents are not lipophilic, only very small quantities cross the placenta and so fetal exposure is limited. These agents are safe to use. #oha

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May 18, 2011
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Nitrous Oxide: Recent epidemiological studies suggest its safe. However, is teratogenic in rats if they are exposed to 50–75% conc for 24hr during peak organogenisis. Sensible to avoid as unecessary #ref

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Aug 20, 2011
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Risk of premature labour in the postoperative period. Women should be told to report sensations of uterine contractions so that appropriate tocolytic therapy can be instituted.

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