Anesthesia and the Fetus by Yehuda Ginosar, Felicity Reynolds, Stephen H. Halpern, Carl

By Yehuda Ginosar, Felicity Reynolds, Stephen H. Halpern, Carl Weiner

Anesthesia and the Fetus integrates into one quantity the multidisciplinary elements of:

  • fetal development
  • fetal pharmacology
  • assessments of fetal and neonatal outcome
  • anesthesia and analgesia in the course of pregnancy
  • anesthesia and analgesia in the course of labor
  • ethics and law

Written by means of an across the world popular staff of clinicians and scientists, Anesthesia and the Fetus offers a modern consultant and connection with the position of anesthesia, and the anesthesiologist, in maintaining the mummy and her unborn baby in the course of pregnancy.

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Extra info for Anesthesia and the Fetus

Sample text

As a result, the placenta essentially becomes a low resistance, low velocity, high-throughput arteriovenous shunt. As blood flow accelerates in the uterine arteries, the increased shear stress on the endothelial surface is a stimulus for increased production of endothelial nitric oxide (NO). Both shear stress and NO have been implicated in expansive (outward) arterial remodeling that is characteristic of the uterine circulation. The veins grow as well, through mechanisms that are poorly understood.

Groopman J. Medical dispatch: The preeclampsia puzzle. Making sense of a mysterious pregnancy disorder. 2006 [July 24] The New Yorker. Young BC, Levine RJ, Karumanchi SA. Pathogenesis of preeclampsia. Annu Rev Pathol 2010; 5:173–92. Wang A, Rana S, Karumanchi SA. Preeclampsia: the role of angiogenic factors in its pathogenesis. Physiology 2009; 24:147–58. Wallukat G, Homuth V, Fischer T, et al. Patients with preeclampsia develop agonistic autoantibodies against the angiotensin AT1 receptor. J Clin Invest 1999; 103: 945–52.

Diastolic murmurs are also relatively common, occurring in about 20% of pregnant women. Finally, a continuous venous hum from enlarged breast vessels (“mammary souffle”) may be mistaken for a continuous cardiac murmur [5]. The gestational increase in cardiac output places additional stress on the heart, and should be a consideration in any patient with acquired heart disease [3]. Fortunately, coronary atherosclerotic lesions are relatively uncommon in women of childbearing age, although previously silent congenital cardiac anomalies may become clinically manifest during gestation.

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