Perioperative Medicine Web-Based Curriculum & Reference

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PERIOPERATIVE MEDICINE

Web-Based Curriculum & Reference

Editors

Kurt J. Pfeifer, MD, FACP

Steven L. Cohn, MD, FACP

Medical College of Wisconsin

State University of New York - Downstate

Pregnancy

Michael P. Carson, MD & David A. Halle, MD

	PREOPERATIVE EVALUATION
	Maternal Risk Factors

	Respiratory Compromise
	Pregnant patients face several perioperative risks due to their impaired respiratory dynamics (see table on right).
	Venous Thromboembolism (VTE)
	Pregnant patients are at increased risk of VTE due to:
	Venous stasis Decreased protein S levels Functional resistance to activated protein C (APC)
	Urinary Tract Infection (UTI)
	Hormonally mediated dilation of the urinary system increases urinary stasis.


LOSS OF AIRWAY
Most common risk of anesthesia in pregnant patients. Fluid retention of pregnancy predisposes to airway edema/friability and hemorrhaging into the airway.
HYPOXIA
Compression of the diaphragm limits the oxygen reserve during apneic periods.
ASPIRATION
Gastric motility is decreased during labor. Lower esophageal tone is decreased.