Chestnut’s Obstetric Anesthesia: Principles and · PDF fileChestnut’s Obstetric Anesthesia: Principles and Practice Fourth Edition David H. Chestnut, MD Director of Medical Education

Chestnut’sObstetric Anesthesia:

Principles and Practice

http://www.us.elsevierhealth.com/product.jsp?isbn=9780323055413&elsca1=doodys&elsca2=PDF&elsca3=Chestnut9780323055413&elsca4=frontmatter

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Chestnut’sObstetric Anesthesia:

Principles and PracticeFourth Edition

David H. Chestnut, MDDirector of Medical Education

Gundersen Lutheran Health SystemProfessor of Anesthesiology

Associate Dean for the Western Academic CampusUniversity of Wisconsin School of Medicine and

Public HealthLa Crosse, Wisconsin

Linda S. Polley, MDAssociate Professor of Anesthesiology

University of Michigan Medical SchoolDirector, Obstetric Anesthesiology

University of Michigan Health SystemAnn Arbor, Michigan

Lawrence C. Tsen, MDAssociate Professor of Anaesthesia

Harvard Medical SchoolDirector of Anesthesia, Center for Reproductive Medicine

Department of Anesthesiology, Perioperative andPain Medicine

Brigham and Women’s HospitalBoston, Massachusetts

Cynthia A. Wong, MDAssociate Professor of Anesthesiology

Northwestern University Feinberg School of MedicineMedical Director, Obstetric Anesthesia

Northwestern Memorial HospitalChicago, Illinois


1600 John F. Kennedy Blvd.Ste 1800Philadelphia, PA 19103-2899

CHESTNUT’S OBSTETRIC ANESTHESIA: ISBN: 978-0-323-05541-3PRINCIPLES AND PRACTICE

Copyright ! 2009, 2004, 1999, 1994 by Mosby, Inc., an affiliate of Elsevier Inc.

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by anymeans, electronic or mechanical, including photocopying, recording, or any information storage and retrievalsystem, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’sRights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333;e-mail: [email protected]. You may also complete your request on-line via the Elsevier websiteat http://www.elsevier.com/permissions.

Notice

Knowledge and best practice in this field are constantly changing. As new research and experiencebroaden our knowledge, changes in practice, treatment, and drug therapy may become necessary orappropriate. Readers are advised to check the most current information provided (i) on proceduresfeatured or (ii) by the manufacturer of each product to be administered, to verify the recommendeddose or formula, the method and duration of administration, and contraindications. It is theresponsibility of the practitioner, relying on his or her own experience and knowledge of the patient,to make diagnoses, to determine dosages and the best treatment for each individual patient, and totake all appropriate safety precautions. To the fullest extent of the law, neither the publisher nor theeditors assume any liability for any injury and/or damage to persons or property arising out of orrelated to any use of the material contained in this book.

The Publisher

Library of Congress Cataloging-in-Publication Data

Chestnut’s obstetric anesthesia : principles and practice / [edited by] David H. Chestnut ... [et al.].– 4th ed.

p. ; cm.Rev. ed. of: Obstetric anesthesia. 3rd ed. 2004.Includes bibliographical references and indexISBN 978-0-323-05541-3

1. Anesthesia in obstetrics. I. Chestnut, David H. II. Title: Obstetric anesthesia.[DNLM: 1. Anesthesia, Obstetrical–methods. 2. Anesthetics. 3. Obstetric Labor

Complications. WO 450 C525 2009].RG732.C44 2009617.9’682–dc22 2008050031

Acquisitions Editor: Natasha AndjelkovicDevelopmental Editor: Anne SnyderPublishing Services Manager: Tina RebaneProject Manager: Norm StellanderDesign Direction: Louis Forgione

Printed in the United States of America

Last digit is the print number: 9 8 7 6 5 4 3 2 1


To my wife, Janet, and our children, Stephen, Annie, Mary Beth, Michael,and John Mark and Catherine

DHC

To my sons, Tad and John

LSP

To my wife, Paulita, our children, London and Hamilton,and my parents-in-law, Deirdre and Oscar

LCT

To my husband, Lawrence, and our children, Anna, Molly, Leah, and Sofie

CAW




Contributors

Susan W. Aucott, M.D.Assistant Professor of PediatricsJohns Hopkins University School of MedicineDirector, Neonatal Intensive Care UnitJohns Hopkins HospitalBaltimore, Maryland

Angela M. Bader, M.D., M.P.H.Associate Professor of AnaesthesiaHarvard Medical SchoolVice Chair for Perioperative MedicineDirector, Weiner Center for Perioperative EvaluationDepartment of Anesthesiology, Perioperative and Pain

MedicineBrigham and Women’s HospitalBoston, Massachusetts

Yaakov Beilin, M.D.Professor of Anesthesiology and Obstetrics,

Gynecology, and Reproductive SciencesVice Chair for QualityCo-Director of Obstetric AnesthesiaMount Sinai School of MedicineNew York, New York

David J. Birnbach, M.D., M.P.H.Professor and Executive Vice Chair of AnesthesiologyDirector, UM-JMH Center for Patient SafetyUniversity of Miami Miller School of MedicineMiami, Florida

David L. Brown, M.D.Chair, Institute of AnesthesiologyCleveland ClinicCleveland, Ohio

Brenda A. Bucklin, M.D.Professor of AnesthesiologyUniversity of Colorado School of MedicineDenver, Colorado

Alexander Butwick, M.B.B.S., FRCAInstructor in AnesthesiaStanford University School of MedicineStanford, California

William Camann, M.D.Associate Professor of AnaesthesiaHarvard Medical SchoolDirector, Obstetric AnesthesiaBrigham and Women’s HospitalBoston, Massachusetts

Katherine Campbell, M.D.Department of Obstetrics, Gynecology, and Reproductive

SciencesYale University School of MedicineNew Haven, Connecticut

Brendan Carvalho, M.B., B.Ch., FRCA,MDCHAssistant Professor of AnesthesiaStanford University School of MedicineStanford, California

Donald Caton, M.D.Professor Emeritus of AnesthesiologyUniversity of Florida College of MedicineGainesville, Florida

Paula D. M. Chantigian, M.D., FACOGObstetrician and GynecologistByron, Minnesota

Robert C. Chantigian, M.D.Associate Professor of AnesthesiologyMayo ClinicRochester, Minnesota

Contributors vii


David H. Chestnut, M.D.Director of Medical EducationGundersen Lutheran Health SystemProfessor of AnesthesiologyAssociate Dean for the Western Academic CampusUniversity of Wisconsin School of Medicine and Public

HealthLa Crosse, Wisconsin

Edward T. Crosby, B.Sc., M.D., FRCPCProfessor of AnesthesiologyFaculty of MedicineUniversity of OttawaOttawa HospitalOttawa, Ontario, Canada

Robert D’Angelo, M.D.Professor and Vice Chair of AnesthesiologySection Head, Obstetric AnesthesiaWake Forest University School of MedicineWinston-Salem, North Carolina

Joanna M. Davies, M.B.B.S., FRCAAssistant Professor of AnesthesiologyUniversity of Washington School of MedicineSeattle, Washington

Kathleen M. Davis, M.D.Assistant Professor of AnesthesiologyUniversity of Maryland School of MedicineBaltimore, Maryland

David D. Dewan, M.D.Professor of Anesthesiology (retirement status)Wake Forest University School of MedicineWinston-Salem, North Carolina

M. Joanne Douglas, M.D., FRCPCClinical Professor of Anesthesiology, Pharmacology and

TherapeuticsFaculty of MedicineUniversity of British ColumbiaBritish Columbia Women’s Hospital and Health CentreVancouver, British Columbia, Canada

Sunil Eappen, M.D.Assistant Professor of AnaesthesiaHarvard Medical SchoolVice-Chair for Clinical AffairsDepartment of Anesthesiology, Perioperative and Pain


James C. Eisenach, M.D.Professor and Vice Chair for ResearchSection of Obstetric AnesthesiaWake Forest University School of MedicineWinston-Salem, North Carolina

Roshan Fernando, M.D., FRCAConsultant Anaesthetist and Honorary Senior LecturerDepartment of AnaesthesiaUniversity College HospitalsLondon, United Kingdom

Michael Froelich, M.D., M.S.Associate Professor of AnesthesiologyUniversity of Alabama at Birmingham School of MedicineBirmingham, Alabama

Robert Gaiser, M.D.Professor of Anesthesiology and Critical CareUniversity of Pennsylvania School of MedicinePhiladelphia, Pennsylvania

Carin A. Hagberg, M.D.Professor and Chair of AnesthesiologyUniversity of Texas Medical School at HoustonHouston, Texas

M. Shankar Hari, M.D., FRCAConsultant in Intensive Care MedicineGuy’s and St. Thomas’ NHS TrustLondon, United Kingdom

Miriam Harnett, M.B., FFARCSIConsultant AnaesthetistCork University Maternal HospitalCork, Ireland

Andrew P. Harris, M.D., M.H.S.Professor of Anesthesiology and Critical Care MedicineJohns Hopkins University School of MedicineBaltimore, Maryland

Joy L. Hawkins, M.D.Professor of AnesthesiologyAssociate Chair for Academic AffairsUniversity of Colorado School of MedicineDirector of Obstetric AnesthesiaUniversity of Colorado HospitalAurora, Colorado

David Hepner, M.D.Assistant Professor of AnaesthesiaHarvard Medical SchoolAssociate Director, Weiner Center for Perioperative

EvaluationDepartment of Anesthesiology, Perioperative and Pain


Norman L. Herman, M.D., Ph.D.Assistant Professor of Anesthesiology (retirement status)Cornell University Medical CollegeNew York, New York

viii Contributors


Paul Howell, B.Sc., M.B., Ch.B., FRCAConsultant AnaesthetistSt. Bartholomew’s HospitalsWest SmithfieldLondon, United Kingdom

Tanya Jones, M.B., Ch.B., MRCP,FRCA

Smiths Medical Research Fellow in Obstetric AnaesthesiaDepartment of AnaesthesiaRoyal Free HospitalLondon, United Kingdom

BettyLou Koffel, M.D.Chief of StaffInterstate Ambulatory SurgicenterPortland, Oregon

Lisa R. Leffert, M.D.Assistant Professor of AnaesthesiaHarvard Medical SchoolCo-Chief, Obstetric AnesthesiaDepartment of Anesthesia and Critical CareMassachusetts General HospitalBoston, Massachusetts

Karen S. Lindeman, M.D.Associate Professor of Anesthesiology and Critical

Care MedicineJohns Hopkins University School of MedicineBaltimore, Maryland

Elizabeth G. Livingston, M.D.Associate Professor of Obstetrics and GynecologyDuke University School of MedicineDurham, North Carolina

Alison Macarthur, B.M.Sc., M.D., M.Sc.,FRCPC

Associate Professor, Faculty of MedicineUniversity of TorontoDepartment of AnesthesiaMount Sinai HospitalToronto, Ontario, Canada

Andrew M. Malinow, M.D.Professor of AnesthesiologyUniversity of Maryland School of MedicineDirector, Obstetric AnesthesiologyUniversity of Maryland Medical SystemBaltimore, Maryland

David C. Mayer, M.D.Professor of Anesthesiology and Obstetrics

and GynecologyUniversity of North Carolina School of MedicineCo-Director of Obstetric AnesthesiologyUniversity of North Carolina HospitalsChapel Hill, North Carolina

Jill M. Mhyre, M.D.Assistant Professor of AnesthesiologyUniversity of Michigan Medical SchoolWomen’s HospitalUniversity of Michigan Health SystemAnn Arbor, Michigan

Marie E. Minnich, M.D., M.M.M.,M.B.A., C.P.E.

Division of AnesthesiologyGeisinger Health SystemDanville, Pennsylvania

Holly A. Muir, M.D., FRCPCChief, Division of Women’s AnesthesiaVice Chair for Clinical OperationsDepartment of AnesthesiologyDuke University Medical CenterDurham, North Carolina

Naveen Nathan, M.D.Instructor of AnesthesiologyNorthwestern University Feinberg School of MedicineChicago, Illinois

Kenneth E. Nelson, M.D.Associate Professor of AnesthesiologySection of Obstetric AnesthesiaWake Forest University School of MedicineWinston-Salem, North Carolina

Warwick D. Ngan Kee, B.H.B., M.B.,Ch.B., M.D., FANZCA, FHKCA,FHKAM

Department of Anaesthesia and Intensive CareThe Chinese University of Hong KongPrince of Wales HospitalShatin, Hong Kong, China

Errol R. Norwitz, M.D., Ph.D.Associate Professor of Obstetrics, Gynecology and

Reproductive SciencesYale University School of MedicineNew Haven, Connecticut

Contributors ix


Geraldine O’Sullivan, M.D., FRCAConsultant AnaesthetistObstetric AnaesthesiaGuy’s and St. Thomas’ NHS TrustLondon, United Kingdom

Peter H. Pan, M.D.Professor of AnesthesiologyDirector of Clinical ResearchSection of Obstetric AnesthesiaWake Forest University School of MedicineWinston-Salem, North Carolina

Joong Shin Park, M.D., Ph.D.Department of Obstetrics and GynecologySeoul National University HospitalSeoul, Korea

Donald H. Penning, M.D., M.Sc., FRCPProfessor of Clinical AnesthesiologyUniversity of Miami Miller School of MedicineMiami, Florida

Linda S. Polley, M.D.Associate Professor of AnesthesiologyUniversity of Michigan Medical SchoolDirector, Obstetric AnesthesiologyUniversity of Michigan Health SystemAnn Arbor, Michigan

Roanne Preston, M.D., FRCPCClinical Associate Professor of AnesthesiologyFaculty of MedicineUniversity of British ColumbiaBritish Columbia Women’s Hospital and Health CentreVancouver, British Columbia, Canada

Robert W. Reid, M.D.Consultant in Critical Care MedicineSaint Luke’s Health SystemKansas City, Missouri

Felicity Reynolds, M.B., B.S., M.D.,FRCA, FRCOG ad eundem

Emeritus Professor of Obstetric AnaesthesiaSt. Thomas’ HospitalLondon, United Kingdom

Mark A. Rosen, M.D.Professor and Vice Chair of Anesthesia and Perioperative

CareProfessor of Obstetrics, Gynecology, and Reproductive

SciencesDirector of Obstetric AnesthesiaUniversity of California San FranciscoSan Francisco, California

Brian K. Ross, M.D., Ph.D.Professor of AnesthesiologyUniversity of Washington School of MedicineSeattle, Washington

Dwight J. Rouse, M.D., M.S.P.H.Professor of Obstetrics and GynecologyUniversity of Alabama at Birmingham School of MedicineBirmingham, Alabama

Eduardo Salas, Ph.D.Professor of PsychologyProgram Director, Human Systems Integration Research

DepartmentInstitute for Simulation and TrainingUniversity of Central FloridaOrlando, Florida

Alan C. Santos, M.D., M.P.H.Professor and Chair of AnesthesiologyOchsner Clinic FoundationNew Orleans, Louisiana

Scott Segal, M.D.Associate Professor of AnaesthesiaHarvard Medical SchoolVice Chair for EducationDepartment of Anesthesiology, Perioperative and Pain


Shiv K. Sharma, M.D., FRCAProfessor of Anesthesiology and Pain ManagementUniversity of Texas Southwestern Medical SchoolDallas, Texas

Kathleen A. Smith, M.D.Assistant Professor of Anesthesiology and Obstetrics and

GynecologyUniversity of North Carolina School of MedicineCo-Director of Obstetric AnesthesiologyUniversity of North Carolina HospitalsChapel Hill, North Carolina

John A. Thomas, M.D.Assistant Professor of AnesthesiologySection of Obstetric AnesthesiaWake Forest University School of MedicineWinston Salem, North Carolina

Alan T. N. Tita, M.D., M.P.H., Ph.D.Department of Obstetrics and GynecologyUniversity of Alabama at Birmingham School of MedicineBirmingham, Alabama

x Contributors


Lawrence C. Tsen, M.D.Associate Professor of AnaesthesiaHarvard Medical SchoolDirector of Anesthesia, Center for Reproductive MedicineDepartment of Anesthesiology, Perioperative and Pain


Marc Van de Velde, M.D., Ph.D.Professor of AnesthesiaDirector, Obstetric AnesthesiaCatholic University LeuvenLeuven, Belgium

Robert D. Vincent, Jr., M.D.Staff AnesthesiologistUniversity of South Alabama Medical CenterMobile, Alabama

Mark S. Williams, M.D., M.B.A., J.D.Clinical Associate Professor of AnesthesiologyUniversity of Alabama at Birmingham School of MedicineSenior Vice-President and Chief Medical OfficerSt. Vincent’s Health SystemBirmingham, Alabama

Richard N. Wissler, M.D., Ph.D.Associate Professor of Anesthesiology and Obstetrics and

GynecologyDirector of Obstetric AnesthesiologyUniversity of Rochester School of Medicine and DentistryRochester, New York

David J. Wlody, M.D.Professor of Clinical AnesthesiologyState University of New York – Downstate Medical

CenterChair of AnesthesiologyLong Island College HospitalBrooklyn, New York

Cynthia A. Wong, M.D.Associate Professor of AnesthesiologyNorthwestern University Feinberg School of MedicineMedical Director, Obstetric AnesthesiaNorthwestern Memorial HospitalChicago, Illinois

Jerome Yankowitz, M.D.Professor of Obstetrics and GynecologyUniversity of Iowa Roy L. and Lucille A. Carver College

of MedicineIowa City, Iowa

Mark I. Zakowski, M.D.Obstetric AnesthesiologyCedars-Sinai Medical CenterLos Angeles, Callifornia

Rhonda L. Zuckerman, M.D.Assistant Professor of Anesthesiology and Critical CareAssistant Professor of Gynecology and ObstetricsJohns Hopkins University School of MedicineBaltimore, Maryland

Contributors xi




Preface

Three decades ago, I could not decide whether I wanted to pursue a career in anesthesiology or obstetrics. So ð I decided todo both. I obtained training in both specialties largely because of my love of perinatal medicine. This text is the result of mydesire to prepare a comprehensive resource for all anesthesia providers (and obstetricians) who provide care for pregnantwomen.

In the preface to the first edition, I identified two goals: (1) to collate the most important information that anesthesiaproviders should know about obstetrics, and (2) to prepare a thorough and user-friendly review of anesthesia care forobstetric patients. I asked each contributor to prepare a comprehensive, scholarly discussion of the subject and also toprovide clear, practical recommendations for clinical practice. As we unveil the fourth edition, those goals remain intact.Further, the fourth edition has undergone a more extensive revision than either the second or the third edition.

First, consider the cover. The maternal-fetal image draws attention to the fact that the anesthesia provider and theobstetrician provide simultaneous care for two (or more) patients – both the mother and her unborn child. As I look at thatimage, I am awestruck by the miraculous beauty of conception, pregnancy, and childbirth.

Second, consider the content. At least 10 chapters – including the chapters on neuraxial labor analgesia, cesareandelivery, the difficult airway, and hypertensive disorders – have been rewritten from start to finish. The three previouslypublished chapters on neuraxial labor analgesia have been consolidated into a single chapter, as have the two previouslypublished chapters on anesthesia for cesarean delivery. All chapters have been updated, and most chapters have undergoneextensive revision. Two new chapters address the important subjects of patient safety and maternal mortality. And thefourth edition – for the first time – features a dedicated website that includes the whole content of the book and is fullysearchable. The book’s interior has been enhanced by the addition of a second color, which allows a better and moreattractive visual presentation.

Third, consider the contributors. The fourth edition includes an astounding number of 32 new contributors! Of specialsignificance is the addition of three outstanding new editors. I hand-picked these new editors as a result of my personalinteraction with them in the preparation of previous editions of this textbook, as well as my familiarity with – and respectfor – the depth and breadth of their knowledge and judgment, and the quality of their scholarship. The title page lists theiracademic affiliations and hospital leadership positions. In addition, Linda S. Polley, M.D., is the current President of theSociety for Obstetric Anesthesiology and Perinatology (SOAP). Lawrence C. Tsen, M.D., is the President-elect of SOAP,and he also serves as Editor-in-Chief of International Journal of Obstetric Anesthesia. And Cynthia A. Wong, M.D., is theobstetric anesthesia section editor for Anesthesia and Analgesia. The addition of these extraordinary obstetric anesthesiol-ogists to the editorial team has resulted not only in the preparation of a better product, but it also reflects the publisher’s(and my own) long-term commitment to this text.

My fellow editors and I should like to acknowledge the important roles of four groups of special people. First, we shouldlike to thank the 72 other talented and distinguished contributors to the fourth edition, as well as the contributors toprevious editions of this text. Without their commitment to this project, the fourth edition would not have seen the light ofday. Second, we should like to gratefully acknowledge the invaluable contributions made by our competent, loyal, and attimes long-suffering assistants: Jennifer Lee and Donna Stortz (DHC); Mary Lou Greenfield (LSP); Judy Johnson (LCT); andAllison Ernt and Sean Jones (CAW). Third, we should like to acknowledge the encouragement, expertise, and attention todetail provided by the professional production team at Elsevier Mosby. And finally, we should like to thank you, the readers,not only for your support of this text through the years, but also for your ongoing commitment to the provision of safe andcompassionate care for pregnant women and their unborn children.

David H. Chestnut, M.D.

Micah 6:8

Preface xiii




Contents

PART IIntroduction

Chapter 1

The History of Obstetric Anesthesia 3Donald Caton

PART IIMaternal and Fetal Physiology

Chapter 2

Physiologic Changes of Pregnancy 15Robert Gaiser

Chapter 3

Uteroplacental Blood Flow 37Warwick D. Ngan Kee

Chapter 4

The Placenta: Anatomy, Physiology, andTransfer of Drugs 55Mark I. Zakowski and Norman L. Herman

Chapter 5

Fetal Physiology 73Kenneth E. Nelson and Andrew P. Harris

PART IIIFetal and Neonatal Assessment and Therapy

Chapter 6

Antepartum Fetal Assessment and Therapy 89Katherine Campbell, Joong Shin Park, and Errol R. Norwitz

Chapter 7

Anesthesia for Fetal Surgery and OtherIntrauterine Procedures 123Mark A. Rosen

Chapter 8

Intrapartum Fetal Assessment and Therapy 141Elizabeth G. Livingston

Chapter 9

Neonatal Assessment and Resuscitation 155Susan W. Aucott and Rhonda L. Zuckerman

Chapter 10

Fetal and Neonatal Neurologic Injury 185Donald H. Penning

PART IVFoundations in Obstetric Anesthesia

Chapter 11

Patient Safety and Team Training 211David J. Birnbach and Eduardo Salas

Chapter 12

Spinal, Epidural, and Caudal Anesthesia:Anatomy, Physiology, and Technique 223Cynthia A. Wong, Naveen Nathan, and David L. Brown

Chapter 13

Local Anesthetics and Opioids 247Alan C. Santos and Brenda A. Bucklin

PART VAnesthesia Before and During Delivery

Chapter 14

Nonanesthetic Drugs during Pregnancy andLactation 285Jerome Yankowitz

Chapter 15

In Vitro Fertilization and Other AssistedReproductive Technology 305Lawrence C. Tsen and Robert D. Vincent, Jr.

Chapter 16

Problems of Early Pregnancy 319Robert C. Chantigian and Paula D. M. Chantigian

Contents xv


Chapter 17

Nonobstetric Surgery during Pregnancy 337Marc Van de Velde

PART VILabor and Vaginal Delivery

Chapter 18

Obstetric Management of Labor andVaginal Delivery 361Alan T. N. Tita and Dwight J. Rouse

Chapter 19

Vaginal Birth after Cesarean Delivery 375David H. Chestnut

Chapter 20

The Pain of Childbirth and Its Effects on theMother and the Fetus 387Peter H. Pan and James C. Eisenach

Chapter 21

Childbirth Preparation and NonpharmacologicAnalgesia 405Marie E. Minnich

Chapter 22

Systemic Analgesia: Parenteral andInhalational Agents 415Roshan Fernando and Tanya Jones

Chapter 23

Epidural and Spinal Analgesia/Anesthesia forLabor and Vaginal Delivery 429Cynthia A. Wong

Chapter 24

Alternative Regional Anesthetic Techniques:Paracervical Block, Lumbar SympatheticBlock, Pudendal Nerve Block, and PerinealInfiltration 493David H. Chestnut

Chapter 25

Postpartum Tubal Sterilization 505Joy L. Hawkins

PART VIICesarean Delivery

Chapter 26

Anesthesia for Cesarean Delivery 521Lawrence C. Tsen

Chapter 27

Postoperative Analgesia: Systemic and LocalTechniques 575David Hepner and Sunil Eappen

Chapter 28

Postoperative Analgesia: Epidural and SpinalTechniques 593Brendan Carvalho and Alexander Butwick

PART VIIIAnesthetic Complications

Chapter 29

Aspiration: Risk, Prophylaxis, andTreatment 633Geraldine O’Sullivan and M. Shankar Hari

Chapter 30

The Difficult Airway: Risks, Prophylaxis, andManagement 651John A. Thomas and Carin A. Hagberg

Chapter 31

Postpartum Headache 677Alison Macarthur

Chapter 32

Neurologic Complications of Pregnancy andNeuraxial Anesthesia 701Felicity Reynolds

Chapter 33

Medicolegal Issues in Obstetric Anesthesia 727Mark S. Williams, Joanna M. Davies, and Brian K. Ross

PART IXObstetric Complications

Chapter 34

Preterm Labor and Delivery 749Holly A. Muir and Cynthia A. Wong

Chapter 35

Abnormal Presentation and MultipleGestation 779BettyLou Koffel

Chapter 36

Fever and Infection 795Scott Segal

Chapter 37

Antepartum and Postpartum Hemorrhage 811David C. Mayer and Kathleen A. Smith

Chapter 38

Embolic Disorders 837Kathleen M. Davis and Andrew M. Malinow

Chapter 39

Maternal Mortality 853Jill M. Mhyre

xvi Contents


PART XThe Parturient with Systemic Disease

Chapter 40

Autoimmune Disorders 869Robert W. Reid

Chapter 41

Cardiovascular Disease 881Miriam Harnett and Lawrence C. Tsen

Chapter 42

Endocrine Disorders 913Richard N. Wissler

Chapter 43

Hematologic and Coagulation Disorders 943Shiv K. Sharma

Chapter 44

Human Immunodeficiency Virus 961David J. Wlody

Chapter 45

Hypertensive Disorders 975Linda S. Polley

Chapter 46

Liver Disease 1009Michael Froelich and Robert W. Reid

Chapter 47

Malignant Hyperthermia 1023M. Joanne Douglas

Chapter 48

Musculoskeletal Disorders 1035Roanne Preston and Edward T. Crosby

Chapter 49

Neurologic and Neuromuscular Disease 1053Angela M. Bader

Chapter 50

Obesity 1079Robert D’Angelo and David D. Dewan

Chapter 51

Renal Disease 1095Yaakov Beilin and Robert W. Reid

Chapter 52

Respiratory Disease in Pregnancy 1109Karen S. Lindeman

Chapter 53

Substance Abuse 1125Lisa R. Leffert

Chapter 54

Trauma 1149Paul Howell

Appendix A

American Society of AnesthesiologistsGuidelines for Regional Anesthesiain Obstetrics 1165

Appendix B

Practice Guidelines for ObstetricAnesthesia: An Updated Report by the AmericanSociety of Anesthesiologists Task Forceon Obstetric Anesthesia 1167

Appendix C

Optimal Goals for Anesthesia Care inObstetrics 1179

Appendix D

Online Resources for Obstetric AnesthesiaProviders 1181William Camann

Index 1185

Contents xvii


Documents

Chestnut’s Obstetric Anesthesia: Principles and · PDF fileChestnut’s Obstetric Anesthesia: Principles and Practice Fourth Edition David H. Chestnut, MD Director of Medical Education