By Robin Russell
This most up-to-date contribution to the FAAM sequence offers a complete and recent dialogue of anaesthetic administration in being pregnant, in the course of supply, and in sufferers present process gynaecological surgical procedure. With authoritative contributions from foreign specialists it's a functional reference for all anaesthetists and professional clinicians.
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Additional info for Anaesthesia for Obstetrics and Gynaecology: Fundamentals of Anaesthesia and Acute Medicine
Decreased intervillous and unchanged myometrial blood flow in supine recumbency. Obstet Gynecol 1980;55:203-5. 15 Kinsella SM, Whitwam JG, Spencer JAD. Aortic compression by the uterus: identification with the Finapres digital arterial pressure instrument. Br J Obsret Gynaecol 1990;97:700-5. 16 Alaily AB, Carrol K. Pulmonary ventilation in pregnancy. Br J Obsret Gynaecol 1978;85:5 18-24. 17 Baldwin GR, Moorthi DS. New lung functions and pregnancy. A m 3 Obstet Gyirecol 1977;127:235-9. 18 Spatling L, Fallenstein F, Huch A, Huch R, Rooth G .
UV values reflect maternal arterial status while UA values reflect more accurately gas and acid-base status of neonatal tissues. Neurobehavioural scores Neonatal neurobehavioural tests assess well-being further into the neonatal period. They examine behavioural responses of the newborn and are used to detect neonatal depression caused by asphyxia or maternal drug administration. T h e Brazelton Neonatal Behavioural Assessment Scale (BNBAS)’ was originally designed to be used clinically and examines primary reflexes, habituation to stimuli, irritability or consolability, and motor tone.
Opioids are basic drugs and most are bound predominantly to (x,-acid glycoprotein. T h e higher concentration of a,-acid glycoprotein in the mother compared with the fetus should, in theory at least, limit placental transfer. However, pethidine is only 40-70% plasma protein bound in the mother (Table 2 . 2 ) and binding is weak, so free drug passes across the placenta readily. 3a) with rapid equilibration between concentrations in maternal arterial (MA) and umbilical venous (W) blood. UV concentrations of free drug therefore mirror maternal plasma concentrations and start to fall within one hour of administration.