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Contents
- Front matter
  - Published and forthcoming Oxford Specialist Handbooks
  - Preface
  - Dedication
  - Contributors
  - Detailed contents
  - Symbols and abbreviations
- Chapter 1 Thinking about obstetric anaesthesia
  - Chapter 1 Thinking about obstetric anaesthesia
  - Surviving the labour ward
  - Asking the right questions OR where do you look for the answers?
  - Dealing with difficult behaviour
  - Dealing with malformation and death
  - The mother who does not speak English
  - Audit in obstetric anaesthesia
  - Further reading
- Chapter 2 Confidential Enquiry into Maternal and Child Health
  - Chapter 2 Confidential Enquiry into Maternal and Child Health
  - Introduction
  - Anaesthesia-related deaths
  - Direct deaths
  - Indirect deaths
  - Further reading
- Chapter 3 Maternal physiology
  - Chapter 3 Maternal physiology
  - Cardiovascular system
  - Respiratory system
  - Renal function
  - Haematological changes
  - Gastrointestinal system
  - Endocrine system
  - Central nervous system
  - Summary of physiological changes relating to anaesthesia
  - Further reading
- Chapter 4 Maternal pathophysiology
  - Chapter 4 Maternal pathophysiology
  - Principles of managing cardiac disease
  - Myocardial disease
  - Cardiac shunts
  - Stenotic cardiac lesions
  - Regurgitant cardiac lesions
  - Pulmonary hypertension
  - Respiratory disease
  - Renal disease
  - Diabetes
  - Coagulation disorders
- Chapter 5 Antenatal issues including pain management
  - Chapter 5 Antenatal issues including pain management
  - Aims of antenatal anaesthetic assessment in high risk pregnancies
  - Suggested referrals to the high risk obstetric anaesthetic clinic
  - Specific problems in the antenatal period
  - Principles of pain management during pregnancy
  - Generic pathway for pain management in pregnancy
  - Pain therapies
  - Safety of pain drugs used in pregnancy
  - Common pain problems
  - Analgesics during lactation
  - Further reading
- Chapter 6 Non-regional labour analgesia
  - Chapter 6 Non-regional labour analgesia
  - Pain in labour
  - Factors influencing the pain of childbirth
  - Information
  - Non-pharmacological options
  - Non-pharmacological—summary
  - Systemic opioids
  - Inhalational analgesia
- Chapter 7 Regional techniques in pregnancy
  - Chapter 7 Regional techniques in pregnancy
  - Introduction/benefits
  - Absolute contraindications
  - Relative contraindications
  - The management of the mother on anticoagulants
  - Consent
  - Monitoring
  - Documentation
  - Positioning the mother
  - Skin preparation
  - Techniques of epidural insertion
  - Difficulties with insertion
  - Bloody tap
  - Accidental dural puncture
  - Techniques of spinal insertion
  - Combined spinal–epidural technique (needle through needle)
  - Removing the epidural catheter
- Chapter 8 Regional analgesia for labour
  - Chapter 8 Regional analgesia for labour
  - Introduction
  - Drugs in the epidural space
  - The test dose
  - Pain scoring
  - Assessing the block
  - Administering analgesia
  - Epidurals that don't work
  - Rescuing the failing epidural
  - Assessing a labour epidural for anaesthesia
  - Combined spinal–epidural analgesia in labour
  - Regional analgesia for early labour
  - Regional analgesia for late labour
- Chapter 9 Anaesthesia for caesarean section: basic principles
  - Chapter 9 Anaesthesia for caesarean section: basic principles
  - Urgency, timing and classification
  - Information and consent
  - Antacid prophylaxis
  - Monitoring mother and fetus
  - Aorto-caval compression
  - Maternal position
  - Intravenous prehydration (preload)
  - Vasopressors
  - Drugs for uterine contraction
- Chapter 10 Anaesthesia for caesarean section: regional anaesthesia
  - Chapter 10 Anaesthesia for caesarean section: regional anaesthesia
  - Introduction
  - Preparation for theatre
  - Assessment of the block
  - Epidural anaesthesia
  - Spinal anaesthesia
  - Combined spinal–epidural (CSE)
  - Common complications
- Chapter 11 Anaesthesia for caesarean section: general anaesthesia
  - Chapter 11 Anaesthesia for caesarean section: general anaesthesia
  - General anaesthesia and CEMACH
  - Indications for general anaesthesia
  - Airway assessment
  - Equipment
  - Intubation
  - Failed intubation
  - Awake fibreoptic intubation
  - Drugs for general anaesthesia
  - Conduct of general anaesthesia
  - Extubation and postoperative care
  - Further reading
- Chapter 12 Postdelivery symptom control
  - Chapter 12 Postdelivery symptom control
  - Analgesia after vaginal delivery
  - Analgesia after caesarean delivery
  - Management of nausea and vomiting
  - Pruritus
- Chapter 13 Anaesthesia and analgesia for specific obstetric indications
  - Chapter 13 Anaesthesia and analgesia for specific obstetric indications
  - Feticide
  - Intrauterine death
  - Breech presentation and abnormal lie
  - Twins and other multiple pregnancies
  - Vaginal delivery after CS (VBAC)
  - Premature fetus
  - Placenta praevia
  - Placenta accreta
  - Controlled rupture of membranes
  - Fetal distress
  - Cord prolapse
  - Placental abruption
  - Instrumental vaginal delivery
  - Uterine inversion
  - Intrauterine fetal surgery
  - EXIT procedures
  - Retained placenta
  - Suturing the perineum
- Chapter 14 Postpartum review and problems
  - Chapter 14 Postpartum review and problems
  - Postdelivery ward round and documentation
  - Maternal satisfaction
  - Advice on drugs and breastfeeding
  - Backache in pregnancy
  - Headache
  - Neurological complications
  - Haematoma
  - Meningitis
  - Arachnoiditis
  - Epidural abscess
  - Cauda equina syndrome
  - Dealing with a complaint
- Chapter 15 Anaesthesia for non-obstetric surgery
  - Chapter 15 Anaesthesia for non-obstetric surgery
  - General principles
  - Fetal considerations
  - Anaesthetic management
  - Further reading
- Chapter 16 Major obstetric haemorrhage
  - Chapter 16 Major obstetric haemorrhage
  - Definition, incidence and impact
  - Organizational aspects
  - Clinical management overview
  - Directed therapy
  - Blood transfusion and coagulation factors
  - New innovations
  - Anaesthesia
  - Continuing care
  - Further reading
- Chapter 17 Pre-eclampsia
  - Chapter 17 Pre-eclampsia
  - Introduction
  - Classification and diagnosis of hypertensive disorders in pregnancy
  - Pathophysiology of pre-eclampsia
  - Antenatal management of pre-eclampsia
  - Severe pre-eclampsia
  - Timing and mode of delivery
  - Fluid balance
  - Eclampsia
  - Intensive care management of severe pre-eclampsia
  - Anaesthetic management of patients with pre-eclampsia
  - Further reading
- Chapter 18 Embolic disease
  - Chapter 18 Embolic disease
  - Venous thromboembolism
  - Amniotic fluid embolus
  - Venous air embolism
- Chapter 19 The collapsed and compromised parturient
  - Chapter 19 The collapsed and compromised parturient
  - Assessment of the critically ill mother
  - Transfer of the critically ill mother
  - Cardiac arrest
  - Perimortem caesarean section
  - High regional blocks: causes
  - High regional blocks: presentation
  - High regional blocks: assessment and management
  - Local anaesthetic toxicity
  - Other drug toxicity
  - Anaphylaxis
  - Aspiration
  - Trauma in the obstetric patient
  - Sepsis
- Chapter 20 The fetus
  - Chapter 20 The fetus
  - Fetal circulation in utero
  - Physiological changes to fetal circulation at delivery
  - Assessment of fetal well-being during pregnancy
  - Assessment of fetal well-being during labour
  - The cardiotocograph
  - Fetal acid–base
  - Effect of analgesia and anaesthesia on the fetus
  - Further reading
- Chapter 21 Controversies in obstetric analgesia
  - Chapter 21 Controversies in obstetric analgesia
  - Feeding in labour
  - Monitoring the mother and fetus with an epidural
  - Mobilizing with an epidural
  - Fever and regional anaesthesia
- Chapter 22 A–Z of conditions in obstetric anaesthesia
  - Chapter 22 A–Z of conditions in obstetric anaesthesia
  - Abdominal pregnancy
  - Achondroplasia
  - Acupuncture
  - Acute epiglottitis
  - Acute fatty liver of pregnancy
  - Addison's disease/crisis
  - Advanced malignancies
  - Alcoholism
  - Amphetamine abuse
  - Amyloidosis
  - Amyotrophic lateral sclerosis
  - Ankylosing spondylitis
  - Antiphospholipid syndrome
  - Antithrombin III deficiency
  - Aortic dissection
  - Aortic stenosis
  - Arnold–Chiari malformations
  - Arthrogryposis multiplex congenital
  - Automatic implantable cardioverters
  - Blalock–Taussig shunts
  - Budd–Chiari syndrome
  - Cardiac tamponade
  - Cardiomyopathy (dilated)
  - Cardiomyopathy (peripartum)
  - Cauda equina syndrome
  - Cell salvage
  - Cerebral tumours/craniotomy
  - Cerebral venous sinus thrombosis
  - C1 esterase deficiency/angioneurotic oedema
  - Chagas disease
  - Charcot–Marie–Tooth disease
  - Chorioamnionitis
  - Cirrhosis
  - Coarctation of the aorta
  - Cocaine abuse
  - Cockayne syndrome
  - CREST syndrome
  - Cushing's syndrome
  - Cyanotic heart disease
  - Cystic fibrosis
  - Demyelinating disease
  - Devic's syndrome
  - Duchenne muscular dystrophy
  - Dysfibrogenaemia
  - Ebstein's anomaly
  - Ehler's–Danlos syndrome
  - Eisenmenger's syndrome
  - Epidermolysis bullosa
  - Epilepsy/pseudoseizures
  - Factor V Leiden
  - Factor XI deficiency
  - Familial hypokalaemic periodic paralysis
  - Familial Mediterranean fever
  - Fontan's procedure
  - Friedreich's ataxia
  - Gaucher's disease
  - Gilbert's disease
  - Glanzmann's thrombasthenia
  - Guillain–Barré syndrome
  - Haemophilia A/haemophilia carrier
  - Heart block
  - Heart–lung transplant
  - Hereditary neuropathy
  - Hereditary spherocytosis
  - Herpes simplex infection
  - HIV infection
  - Horner's syndrome
  - Hypertrophic obstructive cardiomyopathy
  - Hypothyroidism/hyperthyroidism
  - Hypoplastic anaemia
  - Implanted intrathecal pump
  - Intracranial mass/cyst
  - Isaac's syndrome
  - Jehovah's Witness
  - King–Denborough syndrome
  - Klippel–Fleil syndrome
  - Klippel–Trenaunay–Weber syndrome
  - Laparoscopic surgery in pregnancy
  - Larsen syndrome
  - Laryngeal papillomatosis/tracheal stenosis
  - Latex allergy
  - Lipomyelocele
  - Long QT syndrome
  - Ludwig's angina
  - Lymphangioleiomyomatosis
  - Lymphocytic hypohysitis
  - Malignant hyperthermia
  - Marfan's syndrome
  - Mediastinal masses
  - Motor neuron disease (amyotrophic lateral sclerosis)
  - Moyamoya disease
  - Multiple endocrine neoplasia
  - Myasthenia gravis
  - Myelodysplastic syndrome
  - Myocardial ischaemia
  - Myotonic dystrophy
  - Needle phobia
  - Neurofibromatosis
  - Noonan's syndrome
  - Oesophageal varices
  - Opiate addiction
  - Osler–Weber–Rendu (hereditary haemorrhagic telangectasia)
  - Osteogenesis imperfecta
  - Paroxysmal nocturnal haemoglobinuria
  - Pemphigus vulgaris
  - Pneumomediastinum and pneumothorax (Hamman's syndrome)
  - Polychondritis
  - Polycythaemia rubra vera
  - Porphyria
  - Portal hypertension
  - Protein C and S deficiency
  - Pseudoxanthoma elasticum
  - Pulmonary hypertension
  - Quadriplegia with autonomic hyper-reflexia
  - Recombinant factor VIIa
  - Retinal haemorrhage
  - Rheumatoid arthritis
  - Ross procedure
  - Sarcoidosis
  - Scoliosis/corrected spinal surgery
  - Sickle cell disease
  - Spina bifida
  - Spinal muscular atrophy type III (Kugelberg–Welander disease)
  - Sturge–Weber syndrome
  - Subarachnoid haemorrhage
  - Subdural haematoma
  - Superior vena cava obstruction
  - Supraventricular tachycardia
  - Suxamethonium apnoea
  - Syringomyelia
  - Systemic lupus erythematosus
  - Systemic sclerosis
  - Takayasu's disease
  - Thalassaemia
  - Thalidomide deformities
  - Thoracic aortic aneurysm
  - Thrombocytopenia
  - Thrombotic thrombocytopenic purpura
  - Tocolysis
  - Transposition of great vessels
  - Truncus arteriosus
  - Urticaria pigmentosa
  - Valve replacements
  - Varicella
  - Ventriculoperitoneal shunts
  - Von Hippel–Lindau disease
  - Von Willebrand's disease
  - Wegener's granulomatosis
  - Wolff–Parkinson–White syndrome
- Index
  - Index

This title covers all aspects of obstetric anaesthesia the trainee anaesthetist will encounter when on the labour ward, and its accessible style makes it essential reading for other members of the labour ward team.

About the Editors

Paul Clyburn Consultant Anaesthetist, University Hospital of Wales, Cardiff, UK

Rachel Collis Consultant Anaesthetist, University Hospital of Wales, Cardiff, UK

Sarah Harries Consultant Anaesthetist, University Hospital of Wales, Cardiff, UK

Stuart Davies Consultant Anaesthetist, Swansea NHS Trust, UK

Disclaimer: Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.

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