Contributors About the editors Preface 1. Physiological maternal adaptive changes during pregnancy, e.g., alterations of endometrium and decidua, menstruation, placenta, fetal membranes, placental hormones, morphological and functional fetal developmentAmber N. Edinoff, Brooke Williams, Layne Landry, Elyse M. Cornett and Alan David Kaye1. Introduction 2. Estrogen and progesterone in pregnancy 2.1 Progesterone 2.2 Estrogen 2.3 Decidualization 3. Physical changes in pregnancy 3.1 Cardiovascular system 3.2 GI system 3.3 Respiratory system 3.4 Skin 3.5 Sensory 3.6 Hematology 4. Pharmacologic changes in pregnancy 4.1 Absorption 4.2 Distribution 4.3 Metabolism 4.4 Elimination 5. Issues arising from the physiologic changes of pregnancy 5.1 Hypertensive disorders of pregnancy 5.2 Peripartum cardiomyopathy 5.3 Pulmonary changes in pregnancy 5.4 Postpartum depression 6. ConclusionReferences2. Anatomy of the reproductive tract: The placenta, uteroplacental circulation, anatomy, transfer of drugs, and respiratory gas exchangeJessica Galey, Amy Zheng and Shobana Bharadwaj1. Anatomy of the female reproductive tract1.1 Organs1.2 Innervation 1.3 Blood flow1.4 Uterine blood flow changes during pregnancy 2. Anatomy of the placenta2.1 Embryology2.2 Macroscopic anatomy2.3 Maternal vasculature2.4 Fetoplacental vasculature3. Placental physiology3.1 Oxygen transfer3.2 Carbon dioxide transfer 3.3 Acid base3.4 Placental drug transfer3.5 Common drugs used during pregnancy3.6 Anesthetic drugs and placental transfer4. Conclusion3. Uterine blood flow and the effects of obstetric anesthesiaJohn Pallan, Amy Zheng, Jessica Galey and Shobana Bharadwaj1. Introduction2. Anatomy3. Uteroplacental blood flow4. Response to vasoactive agents5. Mechanisms of changes6. Determinants of uterine blood flow7. Measuring uterine blood flow8. Regional anesthesia and uterine blood flow9. Doppler ultrasonography and uterine blood flow10. General anesthesia and uterine blood flow11. Effects of obstetric drugs12. Conclusion4. Perinatal pharmacologyRucha Kelkar, Alina Smoleva, Therese Larson, Sahar Shekoohi and Alan David Kaye1. Definition, background2. Maternal factors3. Placental factors4. Basic fetal pathophysiology and risk factors5. Fetal drug uptake, distribution, metabolism, and excretion6. Related issues, historical trendsReferences5. Parturient anesthesia assessment and evaluationHrayr Ghazaryan, Artush Grigoryan and Lincoln Frederick Arbogast1. Introduction2. History of anesthesia in obstetrics3. Physiological changes in pregnancy3.1 Cardiovascular3.2 Respiratory3.3 Gastrointestinal3.4 Urinary3.5 Endocrine3.6 Hematologic 3.7 Coagulation4. Preanesthesia evaluation of parturients4.1 Past surgical history and anesthetic history4.2 Past obstetric history4.3 Past medical history4.4 Physical examination5. Evaluation of parturient with systemic disease5.1 Cardiovascular diseases 5.2 Respiratory diseases 5.3 Anemias 5.4 Coagulation disorders 6. Endocrine diseases 6.1 Diabetes mellitus 6.2 Hyperthyroidism 6.3 Musculoskeletal disorders 6.4 Renal diseases6.5 Liver diseases7. Conclusion References6. How to create and maintain a safe and an efficient obstetric anesthesia practiceAnjum Anwar, Huma Wali and Hina Shamim1. Introduction2. Maternal care framework in the United States3. Preanesthesia evaluation for obstetric patients 3.1 Background 4. Current state of affairs and challenges 4.1 Recommendations 5. Telemedicine 6. Patient education 7. Intrapartum care for parturient 7.1 Introduction 8. Challenges and recommendations 8.1 Medication shortages 8.2 Staffing and training/anesthesia workforce 8.3 Recommendations 8.4 Anesthesia management of high-risk pregnancies 8.5 Peripartum obstetric hemorrhage 8.6 Concept of the pregnancy heart team and cardiac obstetrics 8.7 Critical care in obstetrics 9. Enhanced recovery after CD 10. Process improvement to enhance patient safety in obstetric anesthesia 11. Handoffs and checklists 12. Simulation and team working in obstetric anesthesia 13.
