Ob Anesthesia Factoids

Front 1

Decrease in Uterine BF with Thiopental

Back 1

20-40%

Front 2

Diagnosis of Preeclampsia (2)

Back 2

After 20 wks of gestation:
1. SBP >140 or DBP >90 in woman with previously normal BP
2. Proteinuria >0.3 g /24h (+1 on dipstick)

Front 3

Incedence of Preeclampsia

Back 3

7% of Pregnancies

Front 4

Normal FHR

Back 4

120-160 bmp

Front 5

Causes of Fetal Bradycardia (4)

Back 5

1. Hypoxia
2. Acidosis
3. Congenital Heart Block
4. Drugs

Front 6

Causes of Fetal Tachycardia (5)

Back 6

1. Infection
2. Fever
3. Maternal Smoking
4. Fetal paroxysmal supraventricular tachycardia
5. Drugs (Atropine, ritrodrine, terbutaline)

Front 7

Diagnosis of Severe Preeclampsia (2 required + 7 other symptoms)

Back 7

After 20 wks of gestation: (BP and proteinuria required)
1. SBP >160 or DBP>110
2. Protenuria >5 g/24 h (+3 on dipstick)

Other symptoms:
1. Oliguria (<500 ml urine/24h)
2. Cerebral or visual disturbances
3. Pulmonary edema
4. Epigastric or RUQ pain
5. Impaired Liver function
6. Thrombocytopenia
7. IUGR

Front 8

Lack of FHR Variability differential (4)

Back 8

1. Drugs (Benzos, opiates, volatile anesthetics, anticholinergics)
2. Fetal asphyxia
3. Anemia
4. Prematurity

Front 9

P50 Fetal Hb

Back 9

20

Front 10

Increase in CO during 1st trimester

Back 10

30-40%

Front 11

Increase in CO at term in pregnancy

Back 11

50%

Front 12

Greatest increase in CO during pregnancy

Back 12

Immediately after delivery

Front 13

Side effects B-agonists (5)

Back 13

1) Tachycardia
2) Hypotension
3) Hypokalemia
4) Hyperglycemia
5) Pulmonary Edema

Front 14

Conditions in pregnancy associated with DIC (5)

Back 14

1) Placental abruption
2) Dead fetus syndrome
3) Amniotic fluid embolism
4) Gram negative sepsis
5) Pregnancy induced HTN

Front 15

Diagnostic criteria for Gestational HTN

Back 15

After 20 wks of gestation:
1. HTN >140/90 without proteinuria
2. Returns to nl BP 12 wks after delivery

Front 16

% of women with Gestational HTN who develop preeclampsia

Back 16

25%

Front 17

Diagnostic criteria for chronic HTN

Back 17

Before 20 wks of gestation:
1. HTN>140/90 with no or stable proteinuria

Front 18

Diagnostic criteria for Preeclampsia superimposed on chronic HTN

Back 18

Before 20 wks of gestation:
1. HTN>140/90
2. New or increasing proteinuria, increasing BP, or HELLP syndrome

Front 19

Uterine BF at term

Back 19

700-900 ml/min

Front 20

Symptoms of Amniotic fluid embolism (5)

Back 20

1. Dyspnea
2. Hypoxemia
3. Hypotension
4. DIC (40%)
5. Seizures (occasionally)

Front 21

APGAR scoring (0,1,2)

Back 21

1) HR (absent, <100, >100)
2) Resp effort (Absent, slow irregular, good crying)
3) Reflex irritability (No response, grimace, cough or sneeze)
4) Muscle Tone (Flaccid, some flexion, active motion)
5) Color (Blue or pale, pink body with blue ext, pink)

Front 22

Increased Respiratory paramaters in pregancy (5)

Back 22

1) Increase TV (40-45%)
2) Increase IRV (5%)
3) Increase Minute Vent (40-45%)
4) Increase PaO2 (103)
5) Increase in O2 Consumption (20-60%)

Front 23

Decreased Respiratory Parameters in pregnancy (6)

Back 23

1) Decreased PaCO2 (30)
2) Decreased Bicarb (4 meQ/Ml)
3) Decreased ERV (20-25%)
4) Decreased RB (15-20%)
5) Decreased FRC (15-20%)
6) Decreased TLC (5%)

Front 24

Unchanged Respiratory Parameter in pregnancy (1)

Back 24

VC

Front 25

Normal fetal O2 consumption

Back 25

7 ml/kg/min

Front 26

Signs of Aspiration pneumonitis (7)

Back 26

1) Bronchospasm
2) Wheezing
3) Dyspnea
4) Tachypnea
5) Tachycardia
6) Hypotension
7) Pink frothy exudates

Front 27

Tx of Aspiration pneumonitis (2)

Back 27

1) PEEP
2) Positive pressure ventilation

Front 28

Definition of Placenta Acreta

Back 28

Abnormally adherent placenta

Front 29

Definition of Placenta Previa

Back 29

Improper implantation of placenta on lower uterine segment

Front 30

Symptoms of Placenta Previa

Back 30

Painless vaginal bleeding that stops spontaneously

Front 31

Magnesium Toxicity effects

Back 31

1) Deep Tendon reflexes lost (10 mEq/L)
2) Heart block, Respiratory paralysis (15 mEq/L)
3) Cardiac arrest (25 mEq/L

Front 32

Treatment Mg toxicity

Back 32

Calcium

Front 33

1st stage of labor

Back 33

Onset of labor to Cervical dilation (10 cm)

Front 34

Pain fibers of 1st stage of labor

Back 34

Autonomic NS through sympathetic fibers T10-L1

Front 35

Pain fibers of 2nd stage of labor

Back 35

Autonomic NS through sympathetic fibers T10-L1 plus Somatic fibers of birth canal (S2-S4)

Front 36

Theraputic range of Mg

Back 36

4-7 mEq/L

Front 37

Variable decels caused by:

Back 37

Umbilical cord compression

Front 38

Late decels caused by:

Back 38

Uteroplacental insufficiancy

Front 39

Early decels caused by:

Back 39

Head compression --> Vagal stimulation

Front 40

Treatment of Uternie Atony

Back 40

1) Oxytocin
2) Prostaglandins
3) Ergot Alkyloids

Front 41

Side efx Prostaglandins:

Back 41

HTN

Front 42

Side efx of Ergot Alkyloids:

Back 42

Bronchospasm, wheezing