Physiology
pulm increased rate tidal volume 30% alveolar vent, decreased FRC, decrease resistance, alkalosis, quick desat
CV increased 50% by week 8, 50 heart rate
uteroplacental 1 L /min, no autoregulation, hence we want to avoid hypotension, aortocaval compression - tilt
increased coag factors, double the coagulating power
100 mL/kg intravascular volume
Anesthetic Considerations
increased sensitivity to neuraxial anesthesia
swollen airway, edema and friable due to estrogen add one Mallampati class
aspiration risk is not significantly higher - GERD, emptying time prolonged ONLY intrapartum, cricoid pressure, no change in fasting guidelines, use non-particular antacids
not all pregnant patients should receive rapid sequence induction
LMA is okay, Mask is okay
Non Obstetric Surgery
get an A-line for CO2
insufflation pressures less than 12 in laparoscopy
have a neonatologist, obstetric, FHR monitoring