Anesthesia for Obstetrics and Gynecology - Maternal Physiology in Pregnancy (Table 32.1)
is a topic covered in the Clinical Anesthesia Procedures
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- Capillary engorgement of the mucosa may occur throughout the respiratory tract, beginning early in the first trimester and increasing throughout pregnancy. Historically, a 6.0- to 6.5-mm (inner diameter) endotracheal tube has been recommended for intubation to decrease the possibility of airway trauma. However, the use of larger tubes may be possible in most patients should it be required. Fluid retention may lead to an enlarged tongue that may explain the increased prevalence of Mallampati class 3 and 4 airways in term parturients compared to the general population. Additionally, the airway exam may change during the course of labor resulting in a further increase in the airway class. Lastly, because of mucosal engorgement, nasotracheal intubation may cause epistaxis and is best avoided in pregnant women.
- Minute ventilation increases by 45% to support the higher oxygen requirements of the mother and fetus and is driven by a proportional increase in tidal volume. As the pregnancy progresses, elevation of the diaphragm from the gravid uterus leads to 20% decrease in maternal functional residual capacity. The resultant decrease in oxygen reserve mandates adequate preoxygenation prior to induction of general anesthesia.
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Pino, Richard M., editor. "Anesthesia for Obstetrics and Gynecology - Maternal Physiology in Pregnancy (Table 32.1)." Clinical Anesthesia Procedures, 9th ed., Wolters Kluwer, 2019. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728341/all/Anesthesia_for_Obstetrics_and_Gynecology___Maternal_Physiology_in_Pregnancy__Table_32_1_.
Anesthesia for Obstetrics and Gynecology - Maternal Physiology in Pregnancy (Table 32.1). In: Pino RM, ed. Clinical Anesthesia Procedures. 9th ed. Wolters Kluwer; 2019. https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728341/all/Anesthesia_for_Obstetrics_and_Gynecology___Maternal_Physiology_in_Pregnancy__Table_32_1_. Accessed October 15, 2019.
Anesthesia for Obstetrics and Gynecology - Maternal Physiology in Pregnancy (Table 32.1). (2019). In Pino, R. M. (Ed.), Clinical Anesthesia Procedures. Available from https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728341/all/Anesthesia_for_Obstetrics_and_Gynecology___Maternal_Physiology_in_Pregnancy__Table_32_1_
Anesthesia for Obstetrics and Gynecology - Maternal Physiology in Pregnancy (Table 32.1) [Internet]. In: Pino RM, editors. Clinical Anesthesia Procedures. Wolters Kluwer; 2019. [cited 2019 October 15]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728341/all/Anesthesia_for_Obstetrics_and_Gynecology___Maternal_Physiology_in_Pregnancy__Table_32_1_.
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