Flashcards in Non-OB sx for the OB pt ppt Deck (42)
perioperative risk include what
_____ - _____% of pregnant women undrgo non-OB sx
trauma complicates ___-___% of surgeries
the nonOB gets how many anesthetics a year?
Cerclage is usually done b/t what age of gestation
contraindications to cerclage
dilation >4 cm
risk with ceclage
what is important to remember about Cardiac and valve sx
CPB is safe
**** Circ arr not rec *** (don't stop all circulation)
a rise any any lab will be alarming but he said one lab inparticular is ALWAYS alarming in prego's what is it
what does progesterone do?
reduce pressure at LES
increase gastric acidity
decreased GB motility
are IV anesthetics Bad for uterine blood flow?
no, there is a small reduction in uterine flow that is dose dependent! only drops if you drop moms pressure
what do VAAs do to uterine blood flow
decrease BP=> lower UBF
Mild changes < 1 MAC
do local anesthetics cause a problem in the uterus?
no, unless you have very high levels
drugs crossing the placenta depend on what?
MW- large drugs don;t cross
Charge- non-ionized cross more than ionized
Protein binding- non protein bound cross easier
lipophilic- higher lipophilicity is advantageous
state 5 drugs that we use that DON'T cross placenta?
State 9 drugs that DO cross the placenta that we use?
what is ion trapping?
fetal blood is slightly more acidic than mothers
a distressed fetus becomes more acidic
weakly basic drugs (LA and Opiates) can cross the placenta
then in acidodic enviroment become ionized and can have trouble crossing back into mothers circulation
this can cause a build up of drug in the fetus
when is the best time for surgeries?
elective sx usually is done when?
> 6 wks post partum
are VAA's teratogens? and why or why not?
b/c unethical to test in prego
LA, VAAs, induction agents, opioids, and MR are all safe for the fetus when?
in clicical circumstances
Name14 teratogenic drugs?
which teratogenic drug was given to girls to prevent excess hight
what was big about Thalidomide and it's teratoginicity
it was OTC in germany and used for morning sickness
gave kids phocomelia (flippers)
Pregnancy cat A
no risk identified in well controlled studies
Pregnancy Cat B
no adequate and well controlled studies in PREGNANT WOMEN, however animal studies have revealed no fetus harm
Pregnancy Cat C
no adequate and well controlled studies in PREGNANT WOMEN, however an adverse effect has been shown in animals
Adequate and well controlled studies in PREGNANT WOMENhave failed to show a risk to the fetus; but an adverse effect has been shown in an animal
Pregnancy Cat D
a risk to the fetus has been demonstrated in adequate, well controlled or observational studies in pregnant women; however the benefits of therapy may outweigh the potential risk
Pregnancy cat X
positive evidence of fetal abnormalities has been demonstrated in adequate well controlled studies or observational studies in pregnant woman or animals, the drug is contraindicated in women who are or may became pregnant