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Obstetrical Analgesia and Anesthesia

What percentage of maternal deaths in the United States are attributable to anesthesia?

a. 0.7%

b. 1.7%

c. 7.0%

d. 17%

A 25-year-old G2P1 is diagnosed with severe preeclampsia, with a platelet count of 40,000/µL, and requires a repeat cesarean delivery. You explain that the safest form of anesthesia is general endotracheal anesthesia. She states she has read in the recent media that anesthesia can be harmful to her fetus and requests more information. Which statement is true?

a. There is a significant lack of data to support the Food and Drug Administration’s warning.

b. Most studies suggest that a single exposure of relatively short duration to general anesthesia has no effect on learning or behavior.

c. The Food and Drug Administration issued a warning that repeated or lengthy use of anesthesia during the third trimester may affect fetal brain development.

d. All of the above

Which statement regarding meperidine is true?

a. It readily crosses the placenta.

b. The neonatal half-life is 1–2 hours.

c. The metabolite normeperidine is not a respiratory depressant.

d. It is associated with higher Apgar scores in comparison to epidural analgesia.

You are called to evaluate an abnormal fetal heart rate tracing for a woman in labor. She recently received an intravenous medication for sedation and reports good pain relief. Ten minutes prior there was moderate variability and accelerations. The tracing is shown below. What is the most likely explanation for the below heart rate tracing?

Used with permission from Dr. Ed Wells and Dr. F.G. Cunningham.

a. Fetal anemia

b. Fetal acidemia

c. Recent remifentanil administration

d. Recent butorphanol administration

A woman underwent a repeat cesarean delivery under spinal analgesia 2 hours ago and now complains of ...

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