Pre-Eclampsia

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Anaesthesia & Gestation: 2 nd Trimester: ‘Best’ time for surgery. Uterine displacement beyond 18-20 weeks. Aspiration prophylaxis, intubate. Minimise uterine manipulation. Careful with ketamine, etc. Tocolysis usually required. Thromboprophylaxis advisable. Dr. Marc Coppens Anaesthesia & Gestation: 3 rd Trimester: CONSIDER DELIVERY FIRST Uterine displacement. Aspiration prophylaxis, intubate. Minimise uterine manipulation. Care with ketamine. Avoid NSAIDs. Tocolytics often required. Thromboprophylaxis. Steroids (< 34 weeks). Dr. Marc Coppens 24
Inhalation • Chloroform: hepatic failure • Ether & cyclopropane: explosion • Halothane: headache, exhaustion, … • 1967: adverse reproductive effects • Halothane in rats: aberrant skeletal development after 12 h exposure • Fink: rats exposed to high concentrations of nitrous oxide: more skeletal abno Prolonged exposure to trace concentrations Single or repeated high dose exposure Dr. Marc Coppens Inhalational anaesthetics • No mutagenic effects ( N 2 O, E,I,D,S ) • No carcinogenic effects • N 2 O is the only inhaled anaesthetic that has been convincingly shown to be directly teratogenic in experimental animals • Interference with DNA synthesis (methionine synthethase) • Consensus: any teratogenic effects caused by changes in physiology ! Dr. Marc Coppens 25
Page 1 and 2: Anaesthesia for the pathologic preg
Page 3 and 4: Thrombocytopenia Endothelium Thromb
Page 5 and 6: Pre-eclampsia: therapy • Vasodila
Page 7 and 8: Magnesium • Vasodilator activity
Page 9 and 10: Anti-hypertensive medication Vasodi
Page 11 and 12: Anti-hypertensive medications • N
Page 13 and 14: Systemic analgesia Pethidine: prolo
Page 15 and 16: Sectio preterm Difference in local
Page 17 and 18: Placental transfer Maternal • blo
Page 19 and 20: Placental transfer Dr. Marc Coppens
Page 21 and 22: Respiratory: • ↑ VO 2 ; ↑ Min
Page 23: Anaesthesia techniques: MAINTAIN NO
Page 27 and 28: Fetal monitoring Fetal heart rate v
Page 29 and 30: Dr. Marc Coppens SUMMARY • Pre-te
Page 31 and 32: Dr. Marc Coppens Anticoagulation
Page 33 and 34: C-section bupi sal bupi sal c sal T
Page 35 and 36: Postpartum hemorrhage Normal blood
Page 37 and 38: Synto: bolus vs infusion Dr. Marc C
Page 39 and 40: Misoprostol Dr. Marc Coppens Postpa
Page 41 and 42: Placenta accreta • Risk factors:
Page 43 and 44: PPROM : complications • Fetal com
Page 45 and 46: Venous thromboembolism • Virchow
Page 47: Suggested reading • Options for s

Pre-Eclampsia

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