Longnecker's Anesthesiology > Part 2. Preparing for Anesthesia > Section B. Preoperative Evaluation of the Anesthesia Patient > Chapter 21. Evaluation of the Pregnant Patient Robert Gaiser, MD

Key Points

"1. Unlike other operations wherein the patient is primarily concerned with him or herself, the pregnant woman usually is concerned for her baby's welfare.

2. The anesthesia provider must be aware of the various physiologic changes of pregnancy and incorporate them into the anesthetic plan.

3. These physiologic changes have implications for various diseases and must be considered.

4. The central nervous system effects of pregnancy include a reduced local anesthetic requirement when these agents are given intrathecally or epidurally.

5. Pregnant patients are at increased risk for aspiration during general anesthesia.

6. There is some suggestion that surgery during the first trimester is linked to central nervous defects during surgery.

7. Fetal heart rate monitoring is possible during some surgical procedures but is not universally used in the United States.

8. Preterm delivery remains the leading cause of perinatal morbidity and mortality in the United States. Preterm labor is difficult to control with medication; the most promising medications are the calcium channel-blocking drugs. Magnesium sulfate is frequently used and is associated with prolonged depolarizing and nondepolarizing neuromuscular blockade.

9. The etiology..."