Quick Hits in Obstetric Anesthesia

477 Pages·2022·25.809 MB·English

by  Roshan Fernando (editor), Pervez Sultan (editor), Sioned Phillips (editor)

Quick Hits
in Obstetric
Anesthesia
Roshan Fernando
Pervez Sultan
Sioned Phillips
Editors
123
Quick Hits in Obstetric Anesthesia
Roshan Fernando Pervez Sultan
(cid:129) (cid:129)
Sioned Phillips
Editors
Quick Hits in Obstetric
Anesthesia
123
Editors
RoshanFernando Pervez Sultan
Department ofAnesthesiology, Intensive Department ofAnesthesiology,
Care andPerioperative Medicine Perioperative andPainMedicine
Women’sWellness andResearch Centre StanfordUniversity Schoolof Medicine
Hamad Medical Corporation Stanford, CA,USA
Doha,Qatar
SionedPhillips
Department ofAnaesthesia
Frimley ParkHospital
Frimley,UK
ISBN978-3-030-72486-3 ISBN978-3-030-72487-0 (eBook)
https://doi.org/10.1007/978-3-030-72487-0
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To my mother and father who asked me to
take up a career in medicine all those years
ago. To Anelia and Nia for being in my life
during the time it has taken to write and
publish the book and for all the fun and
encouragement along the way.
Roshan Fernando
I dedicate this book to my father Dr.
Mohammad Sultan and my mother Maleka
Sultan. Thank you for teaching me
dedication, hard work, self-belief and
perseverance. I also dedicate this book
to the 3 special girls in my life. My wife,
Ellile, who has provided me with limitless
encouragement, strength and support. And
finally, to my 2 daughters, Sofia and Aarya.
Thank you for every moment of joy, I cherish
every second we spend together.
Pervez Sultan
I would like to thank Toc for his support and
advice whilst completing this project.
I dedicate this book to Araz Pourkashanian,
my friend and colleague who was loved by all
on labour ward, you are missed.
Sioned Phillips
Foreword
The demand on obstetric anaesthetists is ever increasing, with the majority of
women being cared for within hospital delivery areas, requiring their services.
Caring for obstetric patients is very different compared to caring for patients in
other surgical settings. Obstetric anaesthetists will frequently administer neuraxial
anaesthesia for surgical procedures while women are awake for their operation.
They must also take into consideration the effects of anaesthesia on the fetus. The
types of obstetric surgical interventions are distinct compared to the routine case-
load encountered by junior anaesthetists in the main operating areas of hospital
facilities.Aswellasthesedifferences,themajorityofsurgerythatoccurswithinthe
delivery area is emergent in nature and requires prompt anaesthetic input. All
of these factors can lead to uncertainty for novice obstetric anaesthetists, and
covering delivery wards can be a daunting prospect for many anaesthetic trainees.
Quick Hits in Obstetric Anesthesia is not only aimed at novice obstetric
anaesthetistsbutisalsointendedforuseasaquickreferenceguidebyallgradesof
anaesthetist. Information is clearly presented and summarises the management of
emergencysituationsandcommonproblemswhichareencounteredwhileworking
with pregnant patients. Different anaesthetic ‘recipes’ and management strategies
are presented for common obstetric procedures in addition to trouble-shooting
chaptersand ‘whatto dolists’for frequentlyencountered dilemmas.Quick Hits in
Obstetric Anaesthesia includes chapters which are written by leading international
experts in the field of obstetric anaesthesia, covering a spectrum of antenatal and
postpartum situations when the input of obstetric anaesthetists to multidisciplinary
team working is key to ensuring excellent patient outcomes.
Brendan Carvalho, MBBCh, FRCA, MDCH
Chief, Division of Obstetric Anesthesia
Department of Anesthesiology
Perioperative and Pain Medicine
Stanford University School of Medicine
Stanford, CA, USA
vii
Contents
1 Epidurals for Labour Analgesia . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Thierry Girard
2 Combined Spinal-Epidural Analgesia for Labour. . . . . . . . . . . . . . 7
Marc Van de Velde
3 Non-neuraxial Options for Labour Analgesia. . . . . . . . . . . . . . . . . 13
Ryan Howle and Tauqeer Husain
4 Management of the Woman with an Intrauterine Fetal Death
(IUFD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Dinesh Das and Nisa Patel
5 Category 4/Planned Caesarean Delivery. . . . . . . . . . . . . . . . . . . . . 25
Wint Mon and Roxaan Jappie
6 Spinal Anaesthesia for Caesarean Delivery. . . . . . . . . . . . . . . . . . . 31
Sioned Phillips and Adrienne Stewart
7 Combined Spinal-Epidural Anaesthesia for Caesarean Delivery. . . 37
Marc Van de Velde
8 Epidural Top-Up for Caesarean Delivery. . . . . . . . . . . . . . . . . . . . 41
Ryan Howle and Tauqeer Husain
9 General Anaesthesia for Caesarean Delivery . . . . . . . . . . . . . . . . . 47
Atif Chaudhary and Robin Russell
10 Hypotension During Spinal Anaesthesia
for Caesarean Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Sarah Ciechanowicz and Adrienne Stewart
11 Pain Relief After Caesarean Delivery . . . . . . . . . . . . . . . . . . . . . . . 59
Amber Naz and Mitko Kocarev
12 Manual Removal of Placenta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Rebecca Brinkler and John Dick
ix
x Contents
13 Cervical Cerclage (Insertion and Removal). . . . . . . . . . . . . . . . . . . 75
David Monks, Pervez Sultan, and Methodius Tuuli
14 External Cephalic Version . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Ruth Shaylor and Carolyn F. Weiniger
15 Artificial Rupture of the Membranes . . . . . . . . . . . . . . . . . . . . . . . 87
Priyanka Sara and Pat O’Brien
16 Consent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Kate McCombe
17 Documentation Standards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Kate McCombe
18 Umbilical Cord Prolapse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Angela Yan, Pervez Sultan, and Patrick O’Brien
19 Expedited and Emergency Caesarean Delivery. . . . . . . . . . . . . . . . 107
Priyanka Sara, Patrick O’ Brien, and Pervez Sultan
20 Operative Vaginal Delivery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
John Dick and Caroline Borkett-Jones
21 Massive Obstetric Haemorrhage. . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Rachel Collis and Lucy French
22 Uterine Atony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Rachel Collis and Lucy French
23 Uterine Inversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Sarah McDonald and Katarzyna Marciniak
24 Amniotic Fluid Embolism. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Neil Muchatuta and Stuart Younie
25 Vaginal Birth After Caesarean Delivery . . . . . . . . . . . . . . . . . . . . . 149
Hadia Farooq, Anwen Gorry, and Suyogi Jigajinni
26 Shoulder Dystocia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Priyanka Sara, Julie Whittington, and Pat O’Brien
27 Normal Labour. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Priyanka Sara, Julie Whittington, and Nicola Lack
28 Cardiotocography (CTG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Muhammad Waseem Athar, Aliya Naz and Fatima Khatoon
29 Antenatal Care for Uncomplicated Pregnancies . . . . . . . . . . . . . . . 177
Shalini Chawla and Pervez Sultan
Contents xi
30 Partogram. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Priyanka Sara and Nicola Lack
31 Induction of Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Angela Yulia, Kate Mayers, Kasia Maksym, and Nicola Lack
32 Augmentation of Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Priyanka Sara and Nicola Lack
33 Pre-term Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Shalini Chawla and Pervez Sultan
34 Malpresentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Angela Yulia, Kasia Maksym, and Nicola Lack
35 Placenta Praevia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Nadir Sharawi, Julie Whittington, and Pervez Sultan
36 Placenta Accreta Spectrum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Nadir Sharawi, Julie Whittington, Pervez Sultan and Shalini Chawla
37 Intrauterine Growth Restriction . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Julie Whittington, Everett F. Magann and Nadir Sharawi
38 Multiple Gestation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Umar Mushtaq and Sikha Shastham Valappil
39 Pre-eclampsia and HELLP Syndrome . . . . . . . . . . . . . . . . . . . . . . 259
Elizabeth Combeer and Namita Sharma
40 Cholestasis of Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Diana Neely, Lisa Long, and Oliver Long
41 Gestational Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Vanessa Cowie
42 Obstetric Venous Thromboembolism . . . . . . . . . . . . . . . . . . . . . . . 281
Matthew Samuel and Sarah Armstrong
43 Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Sarah Armstrong
44 Peri-Partum Cardiomyopathy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Ranil Soysa and Daryl Dob
45 Complex Congenital Heart Disease and Pregnancy . . . . . . . . . . . . 305
Daryl Dob and Clare Ivermee
46 Thrombophilias. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Roulhac D. Toledano and Lisa Leffert