Anesthesia and the Fetus

Anesthesia and the Fetus integrates into one volume the multidisciplinary components of: fetal development fetal pharmacology assessments of fetal and neonatal outcome anesthesia and analgesia during pregnancy anesthesia and analgesia during labor ethics and law Written by an internationally renowned group of clinicians and scientists, Anesthesia and the Fetus provides a contemporary guide and reference to the role of anesthesia, and the anesthesiologist, in protecting the mother and her unborn child during pregnancy. Table of Contents Contributors, ix Preface, xvi Acknowledgments, xviii Section I: Basic Principles 1 Intrauterine growth and development, 3 Timothy Moss, Cheryl Albuquerque & Richard Harding 2 Maternal physiological adaptations to pregnancy, 19 Julie Phillips, MD, Melissa Covington, MD & George Osol, PhD 3 Placental respiratory gas exchange, 25 Lowell Davis 4 The fetal circulation, 32 Loren P. Thompson, PhD & Kazumasa Hashimoto, MD 5 Fetal responses to hypoxia, 39 Tania L. Kasdaglis, MD and Ahmet A. Baschat MD 6 Pharmacokinetics in pregnancy, 53 Janine R Hutson, MSc, Chagit Klieger–Grossmann MD & Gideon Koren MD, FRCPC, FABMT 7 The first few breaths: normal transition from intra– to extra–uterine life, 63 Smadar Eventov–Friedman, MD/PhD & Benjamin Bar–Oz, MD Section II: Endpoint Variables: Assessments of Fetal Wellbeing and Neonatal Outcome 8 Validity of endpoint measurement, 75 Pamela Angle MD MSc, FRCPC, Stephen Halpern MD MSc, FRCPC, Marcos Silva MD & Alex Kiss PhD Section III: Antenatal and Intrapartum Assessment of the Fetus 9 Imaging of the fetus and the uteroplacental blood supply: ultrasound, 89 Kypros Nicolaides 10 Imaging of the fetus and the uteroplacental blood supply: MRI, 97 Caroline Wright & Philip Baker 11 Fetal heart rate monitoring, 104 Alison M. Premo & Sarah J. Kilpatrick 12 Fetal acid–base monitoring, 114 Lennart Nordström 13 Fetal pulse oximetry, 123 Paul B Colditz & Christine East 14 Neonatal assessment and prediction of neonatal outcome, 129 Vadivelam Murthy & Anne Greenough Section IV: Interventions: anesthesia, analgesia, and their effects on the fetus 15 Environmental exposure to anesthetic agents, 141 Asher Ornoy, MD 16 Anesthesia and analgesia for assisted reproduction techniques and during the first trimester, 147 Arvind Palanisamy, MD, FRCA & Lawrence C. Tsen, MD 17 The effect of anesthetic drugs on the developing fetus: considerations in non–obstetric surgery, 156 Richard S. Gist MD CDR MC USN & Yaakov Beilin MD 18 Substance abuse and pregnancy, 165 Donald H. Penning MD, MS, FRCP & Allison J. Lee, MD 19 Intrauterine fetal procedures for congenital anomalies, 173 Amar Nijagal MD, Hanmin Lee MD & Mark Rosen MD 20 The EXIT procedure, 183 Sheldon M. Stohl, MD, Hindi E. Stohl, MD, Ari Y. Weintraub, MD & Kha M. Tran, MD 21 Mechanisms and consequences of anesthetic–induced neuroapoptosis in the developing brain, 192 Zhaowei Zhou, Adam P Januszewski, Mervyn Maze & Daqing Ma 22 Relevance to clinical anesthesia of anesthetic–induced neurotoxicity in developing animals, 200 Catherine E. Creeley, Mervyn Maze & John W. Olney 23 External cephalic version, 210 Carolyn F. Weiniger MB ChB & Yossef Ezra MD Section V: Anesthesia for Cesarean Delivery 24 Effects on the fetus of general versus regional anesthesia, 217 Sharon Orbach–Zinger MD and Yehuda Ginosar BSc MBBS 25 Anesthesia for cesarean delivery: effects on the fetus of maternal blood pressure control, 235 ProfessorWarwick D. Ngan Kee, BHB, MBChB, MD, FANZCA, FHKCA, FHKAM 26 Effects on the fetus of maternal oxygen administration, 244 Neeti Sadana, MD and Scott Segal, MD, MHCM 27 Effects on the fetus of maternal position during cesarean delivery, 251 Robin Russell MB BS MD FRCA Section VI: Analgesia for labor 28 Effects on the fetus of systemic vs. neuraxial analgesia, 263 Stephen H. Halpern MD, MSc, FRCPC & Marcos Silva MD 29 The effects on the fetus of early versus late regional analgesia, 270 Cynthia A. Wong, MD 270 30 Regional analgesia, maternal fever, and its effect on the fetus and neonate, 277 Tabitha A. Tanqueray, Philip J. Steer & Steve M. Yentis 31 Effects on the fetus of major maternal anesthetic complications, 285 Felicity Plaat MA MBBS FRCA & Ruth Bedson MBBS FRCA Section VII: Confounding Variables: The Compromised Fetus, the Compromised Mother 32 Twins and higher order multiple pregnancies: implications for the anesthesiologist, 295 Y. Habaz, J. Barrett & E.S. Shinwell 33 Preeclampsia: the compromised fetus, the compromised mother, 301 Henry L. Galan, MD & Todd R. Lovgren, MD 34 Fetal distress, 313 Robert A Dyer, FCA (SA), PhD & Leann K Schoeman, FCOG (SA) Section VIII: Trauma and Resuscitation 35 Maternal trauma, 325 Yuval Meroz MD, Uriel Elchalal, MD & Avraham I Rivkind, MD FACS 36 Maternal resuscitation and perimortem cesarean delivery, 333 Sharon Einav, MD, Sorina Grisaru–Granovski, MD, PhD & Joseph Varon MD, FACP, FCCP, FCCM 37 Fetal resuscitation, 343 Stephen Michael Kinsella & Andrew Shennan 38 Neonatal resuscitation and immediate neonatal emergencies, 350 Ritu Chitkara, MD, Anand K. Rajani, MD & Louis P. Halamek, MD Section IX: Medicine, Ethics, and the Law 39 Fetal beneficence and maternal autonomy: ethics and the law, 363 William J. Sullivan, QC & M. Joanne Douglas, MD, FRCPC 40 Maternal–fetal research in pregnancy, 372 Frank A. Chervenak, MD & Laurence B. McCullough, PhD Index, 379