TY - CHAP M1 - Book, Section TI - Anesthesia for Obstetric Procedures not Involving Delivery A1 - Soens, Mieke A. A1 - Tsen, Lawrence C. A2 - Santos, Alan C. A2 - Epstein, Jonathan N. A2 - Chaudhuri, Kallol PY - 2015 T2 - Obstetric Anesthesia AB - Clinical obstetric anesthesia is most commonly associated with delivery of an infant; however, there are a number of other obstetric procedures and surgeries where the use of anesthesia can optimize maternal and fetal outcomes. Miscarriage or termination of pregnancy may occur in up to 30% of pregnancies, and when accompanied by retained fetal or placental tissues, removal is accomplished with a dilation and curettage (D&C) or dilation and evacuation (D&E); these typically occur within the first 12 weeks following conception. Between 1% and 2% of pregnancies are associated with an incompetent cervix; a minority of these cases will require cervical cerclage, which is typically placed during the second trimester. Percutaneous umbilical blood sampling (PUBS) is most commonly performed in the second or third trimester for fetal indications, and late in the third trimester, external cephalic version may be attempted to turn a breech fetus into the cephalic position. Tubal ligations are most frequently performed within the first 48 hours’ postpartum, with a second peak occurrence at 6 to 8 weeks’ postpartum, when most of the pregnancy-related changes have resolved. Knowledge of the anatomic and physiologic alterations with different stages of pregnancy, as well as the relevant innervation (Figure 13-1), can optimize the planning and conduct of anesthesia; such knowledge will improve the ability of these procedures to be conducted safely and successfully, and augment the patients’ experience, comfort, and satisfaction. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/07 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1108523194 ER -