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The specialty of obstetric anesthesia has seen enormous growth over the past three decades. In part, this is related to greater expectations from women, as well as the need for anesthetic care that goes beyond routine analgesia for labor or anesthesia for cesarean delivery. More and more, women of reproductive age, with sometimes serious comorbidities, are now able to conceive and carry a pregnancy to term, which often results in the need for complicated obstetric and anesthetic interventions. As such, obstetric anesthesiology has become a truly multidisciplinary specialty, with a focus not only on anesthesiology but also on obstetrics, perinatology, critical care, neonatology, and nursing.
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With these new expectations comes an increased requirement for education and training. Indeed, the Accreditation Council on Graduate Medical Education has recently recognized obstetric anesthesiology as its own separate medical specialty—one that entails a distinct body of knowledge and uniform training requirements. In addition to the need for education of subspecialists as consultants, it is likely that most anesthesiologists will be called on to provide obstetric anesthesia care in the evolving environment alluded to earlier. This book was born out of the need to provide anesthesiologists, and particularly trainees, with a simple and easy reference guide for managing the basics of obstetric anesthesiology and information about the most common obstetric and comorbid conditions.
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The contents of this book follow the structure of a comprehensive textbook, with 30 chapters grouped into 6 sections, with a focus on what is clinically expedient. The role of obstetric anesthesiologists has begun to involve the comprehensive care of women during the puerperium; thus two relevant chapters have been included: Trauma During Pregnancy and Anaphylaxis During Pregnancy. In addition, the usefulness of ultrasound in facilitating neuraxial anesthesia has prompted us to include a chapter dedicated to the use of that technology in obstetric anesthesia. In zone instances, related to clinical frequency, core studies have also been prevented.
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We would like to express our appreciation to our contributors, who have devoted their time and shared their extensive knowledge and experience to make this book possible. The contributing authors of this book are all practicing obstetric anesthesiologists, and also well-regarded academic and clinical anesthesiologists. This group of academic clinicians has helped us attain our goal of highlighting the principles of basic management at the point of clinical care. If readers seek additional knowledge, they are directed to any number of comprehensive specialty textbooks, which may be used to provide supplemental medical knowledge in obstetric anesthesiology that may be beyond the scope of this book.
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We hope that this book provides our colleagues and trainees with the relevant information, comprehensive knowledge, and sincere motivation necessary to maintain the best standards of care for women and their children.