BOOK
Obstetric and Gynecologic Emergencies, An Issue of Critical Care Clinics, E-Book
Peter J. Papadakos | Susan E. Dantoni
(2016)
Additional Information
Book Details
Abstract
This issue of Critical Care Clinics focuses on Obstetric and Gynecologic Emergencies in the ICU. Articles include: Respiratory Failure and Mechanical Ventilation in the Pregnant Patient, Anesthetic Complications in Pregnancy, Neurologic Complications in Pregnancy, Renal Failure in Pregnancy, Management Complex Cardiac Issues in the Pregnant Patient, Liver Failure in Pregnancy, Hypertensive Emergencies in Pregnancy, Ethical Issues in Pregnancy, and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Obstetric and Gynecologic \rEmergencies | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Obstetrics and Gynecology Emergencies\r | vii | ||
| Anesthetic Complications in Pregnancy\r | vii | ||
| Hypertensive Emergencies in Pregnancy\x0B | vii | ||
| Neurologic Complications in Pregnancy\r | vii | ||
| Liver Failure in Pregnancy\r | viii | ||
| Renal Failure in Pregnancy\r | viii | ||
| Respiratory Failure and Mechanical Ventilation in the Pregnant Patient\r | viii | ||
| Management of Complex Cardiac Issues in the Pregnant Patient\r | viii | ||
| Trauma Management of the Pregnant Patient\r | ix | ||
| Maternal Sepsis and Septic Shock\r | ix | ||
| Ethical Issues in Maternal–Fetal Care Emergencies\r | ix | ||
| CRITICAL CARE CLINICS\r | x | ||
| FORTHCOMING ISSUES | x | ||
| April 2016 | x | ||
| July 2016 | x | ||
| October 2016 | x | ||
| RECENT ISSUES | x | ||
| October 2015 | x | ||
| July 2015 | x | ||
| April 2015 | x | ||
| Preface: Obstetrics and Gynecology Emergencies \r | xi | ||
| Anesthetic Complications in Pregnancy | 1 | ||
| Key points | 1 | ||
| THROMBOCYTOPENIA/EPIDURAL HEMATOMA | 1 | ||
| Introduction | 1 | ||
| Risks | 2 | ||
| Combination Therapies | 2 | ||
| Patient Evaluation | 3 | ||
| Summary Discussion | 3 | ||
| AIRWAY | 4 | ||
| Aspiration | 4 | ||
| Aspiration risks | 4 | ||
| Patient evaluation | 4 | ||
| Treatment options | 4 | ||
| Summary/discussion | 4 | ||
| Difficult Airway | 5 | ||
| Introduction | 5 | ||
| Risks of difficult airway | 6 | ||
| Patient evaluation (special consideration of) | 6 | ||
| Planning for airway management | 6 | ||
| NEURAXIAL BLOCKADE | 6 | ||
| Introduction | 6 | ||
| Hypotension | 6 | ||
| Patient evaluation overview | 9 | ||
| Summary/discussion | 9 | ||
| High Spinal | 11 | ||
| Patient evaluation overview | 11 | ||
| Combination therapies | 12 | ||
| Causes | 12 | ||
| Summary/discussion | 13 | ||
| Local Anesthetic Systemic Toxicity | 13 | ||
| Signs/symptoms | 14 | ||
| Combination therapies | 14 | ||
| Summary/discussion | 15 | ||
| Persistent Neuropathy | 15 | ||
| Avoidance of direct trauma during neuraxial anesthesia | 15 | ||
| Evaluation overview | 16 | ||
| Transient Neurologic Symptoms | 18 | ||
| Postdural Puncture Headache | 18 | ||
| Differential diagnosis of postpartum headache | 19 | ||
| Treatment options | 20 | ||
| Epidural blood patch | 20 | ||
| OBSTETRIC LIFE SUPPORT | 21 | ||
| REFERENCES | 22 | ||
| APPENDIX 1 | 23 | ||
| Hypertensive Emergencies in Pregnancy | 29 | ||
| Key points | 29 | ||
| INTRODUCTION | 29 | ||
| Classification of Hypertensive Disorders in Pregnancy | 29 | ||
| Epidemiology of Hypertensive Disorders in Pregnancy | 30 | ||
| PATHOPHYSIOLOGY | 31 | ||
| PATIENT EVALUATION OVERVIEW | 32 | ||
| Diagnosis of Hypertensive Emergencies | 32 | ||
| PHARMACOLOGIC TREATMENT OPTIONS | 32 | ||
| TREATMENT COMPLICATIONS | 34 | ||
| Magnesium Toxicity | 34 | ||
| Medications to Avoid in Pregnancy | 34 | ||
| EVALUATION OF OUTCOME | 37 | ||
| Goals of Treatment | 37 | ||
| Fetal Evaluation | 37 | ||
| Delivery Planning | 37 | ||
| Postpartum Management | 38 | ||
| SUMMARY | 39 | ||
| REFERENCES | 39 | ||
| Neurologic Complications in Pregnancy | 43 | ||
| Key points | 43 | ||
| INTRODUCTION | 43 | ||
| PREECLAMPSIA-ECLAMPSIA | 43 | ||
| Epidemiology and Pathophysiology | 44 | ||
| Clinical Presentation | 44 | ||
| Radiographic Features | 44 | ||
| Management | 45 | ||
| Blood pressure and volume control | 45 | ||
| Intracranial dynamics | 45 | ||
| Termination of pregnancy | 46 | ||
| HEMOLYSIS, ELEVATED LIVER ENZYME LEVELS, AND LOW PLATELET LEVELS SYNDROME | 46 | ||
| Pathophysiology and Clinical Features | 46 | ||
| Management | 46 | ||
| MYASTHENIA GRAVIS | 46 | ||
| Clinical Course | 47 | ||
| Management | 47 | ||
| GUILLAIN-BARRÉ SYNDROME | 48 | ||
| Epidemiology | 48 | ||
| Management | 48 | ||
| STROKE | 48 | ||
| Ischemic Stroke | 49 | ||
| Hemorrhagic Stroke | 51 | ||
| Cerebral Sinus Thrombosis | 52 | ||
| STATUS EPILEPTICUS | 52 | ||
| BRAIN DEATH | 53 | ||
| REFERENCES | 54 | ||
| Liver Failure in Pregnancy | 61 | ||
| Key points | 61 | ||
| INTRODUCTION | 61 | ||
| NORMAL LIVER FUNCTION DURING PREGNANCY | 62 | ||
| PREGNANCY-RELATED CAUSES OF LIVER FAILURE | 62 | ||
| Acute Fatty Liver of Pregnancy | 62 | ||
| Hemolysis, Elevated Liver Enzymes, Low Platelet Syndrome | 64 | ||
| Acute Hepatic Rupture | 64 | ||
| PREEXISTING OR UNRELATED CAUSES OF LIVER FAILURE DURING PREGNANCY | 65 | ||
| Acetaminophen and Toxic Overdose | 65 | ||
| Viral Infections | 65 | ||
| Acute on Chronic Liver Failure | 66 | ||
| MANAGEMENT | 66 | ||
| Acute Liver Failure | 66 | ||
| Chronic Liver Failure | 68 | ||
| Transplantation | 69 | ||
| SUMMARY | 70 | ||
| REFERENCES | 70 | ||
| Renal Failure in Pregnancy | 73 | ||
| Key points | 73 | ||
| INTRODUCTION | 73 | ||
| PATIENT EVALUATION OVERVIEW | 74 | ||
| ETIOLOGY | 75 | ||
| TREATMENT | 77 | ||
| PHARMACOLOGIC TREATMENT OPTIONS | 78 | ||
| NONPHARMACOLOGIC TREATMENT OPTIONS | 79 | ||
| SURGICAL TREATMENT OPTIONS | 80 | ||
| EVALUATION OF OUTCOME AND LONG-TERM RECOMMENDATIONS | 80 | ||
| SUMMARY | 82 | ||
| REFERENCES | 82 | ||
| Respiratory Failure and Mechanical Ventilation in the Pregnant Patient | 85 | ||
| Key points | 85 | ||
| INTRODUCTION | 86 | ||
| PHYSIOLOGIC CHANGES OF RESPIRATORY SYSTEM IN PREGNANCY | 86 | ||
| DETERMINANTS OF OXYGEN DELIVERY AND HYPOXEMIA IN THE FETUS | 86 | ||
| CAUSES OF RESPIRATORY FAILURE IN PREGNANCY | 86 | ||
| Pneumonia | 86 | ||
| Exacerbation of Asthma | 87 | ||
| Pulmonary Edema | 88 | ||
| Aspiration | 88 | ||
| Pulmonary Embolism | 89 | ||
| Air Embolism | 89 | ||
| Pneumothorax in Trauma | 89 | ||
| Amniotic Fluid Embolism | 89 | ||
| Acute Respiratory Distress Syndrome in Pregnancy | 90 | ||
| OXYGENATION GOAL IN PREGNANCY | 90 | ||
| MECHANICAL VENTILATION IN PREGNANCY | 91 | ||
| Endotracheal Intubation | 91 | ||
| Ventilator Settings | 91 | ||
| Noninvasive Ventilation | 92 | ||
| Sedation for Mechanical Ventilation | 92 | ||
| Does Delivery Improve Respiratory Failure? | 92 | ||
| REFERENCES | 93 | ||
| Management of Complex Cardiac Issues in the Pregnant Patient | 97 | ||
| Key points | 97 | ||
| INTRODUCTION | 97 | ||
| MANAGEMENT GOALS | 98 | ||
| Maternal Physiology | 98 | ||
| Fetal Oxygenation | 98 | ||
| PHARMACOLOGIC STRATEGIES | 99 | ||
| Vasopressor Effects on Uterine Artery Blood Flow and Fetal Oxygenation | 99 | ||
| Pharmacologic Agents in Valvular Heart Disease | 101 | ||
| NONPHARMACOLOGIC MANAGEMENT STRATEGIES | 102 | ||
| Valvular Heart Disease of Pregnancy | 102 | ||
| FETAL EVALUATION | 104 | ||
| DISCUSSION | 105 | ||
| REFERENCES | 105 | ||
| Trauma Management of the Pregnant Patient | 109 | ||
| Key points | 109 | ||
| INTRODUCTION | 109 | ||
| EPIDEMIOLOGY | 110 | ||
| ANATOMY AND PHYSIOLOGY OF PREGNANCY | 110 | ||
| Anatomic Considerations | 110 | ||
| Cardiovascular Physiology | 110 | ||
| Hematology | 111 | ||
| Respiratory Physiology | 111 | ||
| Gastrointestinal Physiology | 111 | ||
| ASSESSMENT AND MANAGEMENT | 112 | ||
| Primary Survey | 112 | ||
| Secondary Survey | 112 | ||
| PREGNANCY-ASSOCIATED PATHOLOGY | 113 | ||
| Preeclampsia and Eclampsia | 113 | ||
| Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome | 113 | ||
| Amniotic Fluid Embolism | 113 | ||
| INJURY PREVENTION | 113 | ||
| Seatbelt Use | 114 | ||
| Domestic Violence | 114 | ||
| RADIOLOGY | 114 | ||
| OUTCOMES | 115 | ||
| PERIMORTEM CESAREAN SECTION | 115 | ||
| REFERENCES | 116 | ||
| Maternal Sepsis and Septic Shock | 119 | ||
| Key points | 119 | ||
| INCIDENCE AND MORTALITY | 119 | ||
| DEFINITION | 120 | ||
| PATHOPHYSIOLOGY OF SEPSIS | 121 | ||
| Immunologic Changes During Pregnancy | 121 | ||
| IDENTIFICATION/SCORING SYSTEMS | 124 | ||
| Risk Factors | 124 | ||
| PREVENTION | 125 | ||
| Special Considerations: Maternal Cardiopulmonary Physiology and Fetal Oxygenation | 125 | ||
| INFECTIONS DURING PREGNANCY AND THE PUERPERIUM: COMMON SITES THAT MAY LEAD TO SEPSIS AND ETIOLOGIC ORGANISMS | 127 | ||
| PREGNANCY-ASSOCIATED GROUP A STREPTOCOCCAL INFECTIONS | 127 | ||
| BACTERIAL PNEUMONIA | 128 | ||
| PYELONEPHRITIS | 128 | ||
| CHORIOAMNIONITIS | 129 | ||
| ENDOMETRITIS | 129 | ||
| MANAGEMENT | 130 | ||
| SUMMARY | 131 | ||
| ACKNOWLEDGMENTS | 131 | ||
| REFERENCES | 131 | ||
| Ethical Issues in Maternal–Fetal Care Emergencies | 137 | ||
| Key points | 137 | ||
| INTRODUCTION | 137 | ||
| LIFE OF THE FETUS VERSUS LIFE OF THE MOTHER AND SITUATIONS OF QUESTIONABLE MATERNAL DECISION MAKING | 138 | ||
| WITHDRAWAL OF CARE IN A BRAIN-DEAD PREGNANT PATIENT | 140 | ||
| Terminology | 140 | ||
| DOMESTIC VIOLENCE AND THE PREGNANT PATIENT | 141 | ||
| SUMMARY | 142 | ||
| REFERENCES | 142 | ||
| Index | 145 |