Baysinger & Gambling |All 1-33 Chapters Covered With Questions And Verified
Solutions With Detailed Rationales And Case Studies.
, TABLE OF CONTENT
• SECTION I: Pharmacology and Physiology
Expandable section
o 1: Physiologic Changes of Pregnancy
o 2: Uteroplacental Anatomy, Blood Flow, Respiratory Gas Exchange, Drug Transfer, and
Teratogenicity
o 3: Local Anesthetics and Toxicity
o 4: Obstetric Medications
• SECTION II: Antepartum Considerations
Expandable section
o 5: Ethical and Legal Considerations in Obstetric Anesthesia
o 6: Nonobstetric Surgery during Pregnancy
• SECTION III: Labor and Delivery
Expandable section
o 7: Fetal Assessment and Monitoring
o 8: Maternal Infection and Fever
o 9: Non-neuraxial Analgesic Techniques
o 10: Choice of Neuraxial Analgesia and Local Anesthetics
o 11: Ultrasound and Echocardiographic Techniques in Obstetric Anesthesia
o 12: Impact of Neuraxial Analgesia on Obstetric Outcomes
o 13: Anesthetic Considerations for Women Receiving Cesarean Delivery
o 14: Difficult Airway Management in the Pregnant Patient
o 15: Anesthesia for Multiple Gestation and Breech Presentation
o 16: Obstetric Emergencies
o 17: Newborn Resuscitation
• SECTION IV: Postpartum Issues
Expandable section
o 18: Postcesarean Analgesia
o 19: Management of Postdural Puncture Headache
o 20: Neurologic Deficits Following Labor and Delivery
o 21: Postpartum Tubal Ligation
, • SECTION V: Disease States
Expandable section
o 22: Hypertensive Disorders of Pregnancy
o 23: Endocrine Disorders
o 24: Thrombophilias/Coagulopathies
o 25: Cardiac Disease in the Obstetric Patient
o 26: Neurologic and Neuromuscular Disease
o 27: Renal and Hepatic Disease in the Pregnant Patient
o 28: Obstetric Anesthesia for Parturients with Respiratory Diseases
o 29: Obesity and Pregnancy
o 30: Trauma in the Obstetric Patient
o 31: Management of the Opioid Dependent Parturient
o 32: Maternal Morbidity and Mortality
• SECTION VI: Guidelines From National Organizations
Expandable section
o 33: Guidelines from National Organizations
Chapter 1: Physiologic Changes of Pregnancy
Note: This chapter covers the profound physiologic adaptations that occur across every organ system during
pregnancy. These changes are essential for supporting fetal development and preparing the mother for labor and
delivery, but they also have critical implications for anesthetic management. The 14th Edition of this text
emphasizes that many "abnormal" laboratory and physical findings in pregnancy are actually normal physiologic
adaptations.
Multiple Choice Questions
Question 1
Which of the following best describes the primary hemodynamic change in pregnancy?
A) A high-resistance, low-flow system
B) A high-flow, low-resistance arteriovenous shunt
C) A low-flow, low-resistance system
D) A high-resistance, high-flow system
, Correct Answer: B
Rationale: Pregnancy creates a high-flow, low-resistance arteriovenous shunt state. Cardiac output increases
significantly while systemic vascular resistance decreases to accommodate the increased blood volume and
metabolic demands .
Why other options are incorrect:
• A, D: Pregnancy is characterized by low, not high, resistance.
• C: Pregnancy involves high, not low, flow.
Question 2
By approximately how much does maternal plasma volume increase during pregnancy?
A) 10–15%
B) 20–30%
C) 40–50%
D) 60–70%
Correct Answer: C
Rationale: Plasma volume increases by nearly 50% during pregnancy. This increase is greater than the increase
in red blood cell mass, leading to the physiologic anemia of pregnancy .
Why other options are incorrect:
• A, B: These underestimate the increase.
• D: This overestimates the increase.
Question 3
What is the primary mechanism for the rapid oxygen desaturation observed in pregnant patients during periods
of apnea?
A) Increased maternal oxygen consumption
B) A 20% reduction in functional residual capacity (FRC)
C) Decreased minute ventilation
D) Leftward shift of the oxyhemoglobin dissociation curve
Correct Answer: B
Rationale: The gravid uterus elevates the diaphragm, reducing functional residual capacity (FRC) by
approximately 20%. This reduces the oxygen reserve, causing rapid desaturation during apnea .
Why other options are incorrect:
• A: Oxygen consumption does increase, but the FRC reduction is the primary reason for rapid
desaturation.
• C: Minute ventilation actually increases in pregnancy.
• D: The curve shifts right (Bohr effect) to facilitate oxygen offloading to the fetus.