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In up to 2% of women, pregnancies are complicated by the need for nonobstetric surgical procedures. Optimum management is essential to provide safe anesthesia to the mother and minimize the risk of preterm labor.
Physiologic changes in pregnancy Respiratory:increased minute ventilation with chronic respiratory alcalosis, reduction of functional residual capacity, difficult airway (weight gain, edema of upper airway and vocal cord) Cardiac changes: increased cardiac output, decresed systemic and pulmonary vascular resistance; aortocaval compression with supine hypotension Hematologic changes: blood volumen expansion, dilutional anemia; benign leukocitosis (up to 15000in pregnancy and up to 20000 in labour); hypercoagulable state with high risk for thromboembolism Gastrointestinal system: reduction in lower esophageal sphincter tone, mechanical change of the angle of the gastroesophageal sphincter; increase in gastric acidity; muscle dysrrythmia with nausea, vomiting; Central and peripheral nervous system: increased sensitivity to volatile anesthetics and local anesthetics; reduced volume of epidural and subarachnoid space References Nı´ Mhuireachtaigh R, O’Gorman D: Anesthesia in pregnant patients for nonobstetric surgery. Journal of Clinical Anesthesia (2006) 18, 60–66
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