Anesthesia and the Fetus

Description

This book covers all aspects of anesthesia affecting the fetus throughout in utero life. The book comprises three sections looking at: 1) endpoints for fetal and neonatal outcomes, 2) anesthetic interventions that may affect these endpoint variables, and 3) confounding variables which may modify the effects of anesthesia and analgesia on outcomes. A concise, practical guide backed up by theory, it also discusses wider ethical and legal considerations. With increasing uses of anesthesia throughout pregnancy, this book makes anesthetists and obstetricians aware of the potential effects of anesthetics on fetal development and outcomes.

Table of contents

Contributors
Preface
Acknowledgments

Section I: Basic Principles

• 1 Intrauterine growth and development, 3
  Timothy Moss, Cheryl Albuquerque & Richard Harding
• 2 Maternal physiological adaptations to pregnancy, 19
  Julie Phillips, MD, Melissa Covington, MD & George Osol, PhD
• 3 Placental respiratory gas exchange, 25
  Lowell Davis
• 4 The fetal circulation, 32
  Loren P. Thompson, PhD & Kazumasa Hashimoto, MD
• 5 Fetal responses to hypoxia, 39
  Tania L. Kasdaglis, MD and Ahmet A. Baschat MD
• 6 Pharmacokinetics in pregnancy, 53
  Janine R Hutson, MSc, Chagit Klieger-Grossmann MD & Gideon Koren MD, FRCPC, FABMT
• 7 The first few breaths: normal transition from intra- to extra-uterine life, 63
  Smadar Eventov-Friedman, MD/PhD & Benjamin Bar-Oz, MD

Section II: Endpoint Variables: Assessments of Fetal Wellbeing and Neonatal Outcome

• 8 Validity of endpoint measurement, 75
  Pamela Angle MD MSc, FRCPC, Stephen Halpern MD MSc, FRCPC, Marcos Silva MD & Alex Kiss PhD

Section III: Antenatal and Intrapartum Assessment of the Fetus

• 9 Imaging of the fetus and the uteroplacental blood supply: ultrasound, 89
  Kypros Nicolaides
• 10 Imaging of the fetus and the uteroplacental blood supply: MRI, 97
  Caroline Wright & Philip Baker
• 11 Fetal heart rate monitoring, 104
  Alison M. Premo & Sarah J. Kilpatrick
• 12 Fetal acid-base monitoring, 114
  Lennart Nordström
• 13 Fetal pulse oximetry, 123
  Paul B Colditz & Christine East
• 14 Neonatal assessment and prediction of neonatal outcome, 129
  Vadivelam Murthy & Anne Greenough

Section IV: Interventions: anesthesia, analgesia, and their effects on the fetus

• 15 Environmental exposure to anesthetic agents, 141
  Asher Ornoy, MD
• 16 Anesthesia and analgesia for assisted reproduction techniques and during the first trimester, 147
  Arvind Palanisamy, MD, FRCA & Lawrence C. Tsen, MD
• 17 The effect of anesthetic drugs on the developing fetus: considerations in non-obstetric surgery, 156
  Richard S. Gist MD CDR MC USN & Yaakov Beilin MD
• 18 Substance abuse and pregnancy, 165
  Donald H. Penning MD, MS, FRCP & Allison J. Lee, MD
• 19 Intrauterine fetal procedures for congenital anomalies, 173
  Amar Nijagal MD, Hanmin Lee MD & Mark Rosen MD
• 20 The EXIT procedure, 183
  Sheldon M. Stohl, MD, Hindi E. Stohl, MD, Ari Y. Weintraub, MD & Kha M. Tran, MD
• 21 Mechanisms and consequences of anesthetic-induced neuroapoptosis in the developing brain, 192
  Zhaowei Zhou, Adam P Januszewski, Mervyn Maze & Daqing Ma
• 22 Relevance to clinical anesthesia of anesthetic-induced neurotoxicity in developing animals, 200
  Catherine E. Creeley, Mervyn Maze & John W. Olney
• 23 External cephalic version, 210
  Carolyn F. Weiniger MB ChB & Yossef Ezra MD

Section V: Anesthesia for Cesarean Delivery

• 24 Effects on the fetus of general versus regional anesthesia, 217
  Sharon Orbach-Zinger MD and Yehuda Ginosar BSc MBBS
• 25 Anesthesia for cesarean delivery: effects on the fetus of maternal blood pressure control, 235
  ProfessorWarwick D. Ngan Kee, BHB, MBChB, MD, FANZCA, FHKCA, FHKAM
• 26 Effects on the fetus of maternal oxygen administration, 244
  Neeti Sadana, MD and Scott Segal, MD, MHCM
• 27 Effects on the fetus of maternal position during cesarean delivery, 251
  Robin Russell MB BS MD FRCA

Section VI: Analgesia for labor

• 28 Effects on the fetus of systemic vs. neuraxial analgesia, 263
  Stephen H. Halpern MD, MSc, FRCPC & Marcos Silva MD
• 29 The effects on the fetus of early versus late regional analgesia, 270
  Cynthia A. Wong, MD 270
• 30 Regional analgesia, maternal fever, and its effect on the fetus and neonate, 277
  Tabitha A. Tanqueray, Philip J. Steer & Steve M. Yentis
• 31 Effects on the fetus of major maternal anesthetic complications, 285
  Felicity Plaat MA MBBS FRCA & Ruth Bedson MBBS FRCA

Section VII: Confounding Variables: The Compromised Fetus, the Compromised Mother

• 32 Twins and higher order multiple pregnancies: implications for the anesthesiologist, 295
  Y. Habaz, J. Barrett & E.S. Shinwell
• 33 Preeclampsia: the compromised fetus, the compromised mother, 301
  Henry L. Galan, MD & Todd R. Lovgren, MD
• 34 Fetal distress, 313
  Robert A Dyer, FCA (SA), PhD & Leann K Schoeman, FCOG (SA)

Section VIII: Trauma and Resuscitation

• 35 Maternal trauma, 325
  Yuval Meroz MD, Uriel Elchalal, MD & Avraham I Rivkind, MD FACS
• 36 Maternal resuscitation and perimortem cesarean delivery, 333
  Sharon Einav, MD, Sorina Grisaru-Granovski, MD, PhD & Joseph Varon MD, FACP, FCCP, FCCM
• 37 Fetal resuscitation, 343
  Stephen Michael Kinsella & Andrew Shennan
• 38 Neonatal resuscitation and immediate neonatal emergencies, 350
  Ritu Chitkara, MD, Anand K. Rajani, MD & Louis P. Halamek, MD

Section IX: Medicine, Ethics, and the Law

• 39 Fetal beneficence and maternal autonomy: ethics and the law, 363
  William J. Sullivan, QC & M. Joanne Douglas, MD, FRCPC
• 40 Maternal-fetal research in pregnancy, 372
  Frank A. Chervenak, MD & Laurence B. McCullough, PhD

Index, 379