Features

Practical techniques discussed and potential pitfalls emphasised
Tips for successful practice highlighted throughout
Figures, flow charts, tables and algorithms used to summarise important information
Key references for further reading - both for exams and day-to-day practice
Each chapter concludes with a list of key summary points

Contents

SECTION 1 PRE-CONCEPTION & CONCEPTION

Preconception anaesthesia
Assisted conception
Ovary hyperstimulation

SECTION 2 PREGNANCY

1 Procedures in Early Pregnancy
Cervical suture
Ectopic pregnancy
Termination of pregnancy
ERPC

2 Normal Pregnancy and Delivery
Vertebral and spinal anatomy
Spinal epidural anaesthesia
Spinal extradural opioids
Intrapartum fetal monitoring
External cephalic version
Feeding in labour
Combined spinal and epidural anaesthesia and analgesia
Continuous spinal anaesthesia
Cortical vein thrombosis
Caudal block
Physiology of pregnancy
Aortocaval complications
Pharmacology in pregnancy (kinetics)
Placental transfer of drugs
Administration of drugs by midwives
Antenatal fetal monitoring
Normal labour
Gastric function and feeding in labour
Fluids in labour
Monitoring in labour (including partogram)
Pain of labour
Non-pharmacological analgesia
Systemic analgesics
Inhaled analgesics
Local anaesthetics
Epidural analgesia for labour
Inadequate epidural analgesia
Spinal anaesthesia for Caesarean section
Loss of resistance technique
Epidural test doses
Caudal analgesia

3 Problems Not Confined to Obstetrics
Psychiatric disease
Sickle cell disease
Spinal cord injury
Spinal cord disease
Guillaine-Barre syndrome
Benign intracranial hypertension
Incidental surgery during pregnancy
Obesity
Substance abuse
Adverse drug reactions
Psychological disorders
Fever in labour
Sepsis
Herpes simplex
HIV infection
Hepatitis
Musculoskeletal disorders (general)
Low back pain
Kyphoscoliosis
Cervical spine disorders
Rheumatoid arthritis
Sarcoidosis
Connective tissue disorders
Steroid therapy
Endocrine disease (general)
Diabetes mellitus
Neurological disease - intracranial
Neurological disease - spinal
Neurological disease - peripheral
Epilepsy
Multiple sclerosis
Spina bifida
Migraine
Haematological disease - bleeding and clotting (general)
Deep vein thrombosis/PE
Anticoagulant therapy
Bleeding disorders
Thrombocytopenia and thrombophilia
Hypercoagulation
Anaemia
Polycythaemia
Haemoglobinopathies
Latex allergy
Renal failure
Transplantation
Malignant disease
Lymphoma/leukaemia
Respiratory disease (general)
Restrictive lung disease
Asthma
Air embolism
Bronchiectasis
Cystic fibrosis
Cardiovascular disease - general
Congenital heart disease (incl non-congenital)
Aortic coarction
Pulmonary hypertension & Eisenmenger's syndrome
Prosthetic heart valves
Ischaemic heart disease
Arrhythmias
Cardiomyopathy
Cardiac failure (differential diagnosis)
Invasive monitoring
Intensive care in pregnancy
Acute lung injury

4 Obstetric "Medical" Emergencies
Postpartum haemorrhage
Maternal cardiopulmonary resuscitation in pregnancy
Coarctation of the aorta
Collapse in labour ward
Anaphylaxis and adverse drug reactions
Amniotic fluid embolism
Convulsions
Major haemorrhage
CPR in pregnancy

5 Problems Confined to Obstetrics
Myasthenia gravis
Acute fatty liver of pregnancy
Hyperemesis gravidarum
HELLP syndrome
Intrauterine surgery
Pre-eclampsia & eclampsia
Magnesium
Placenta praevia
Placental abruption
Multiple pregnancy
Malpresentations/positions
ECV
Cord prolapse
Trial of scar
Underage pregnancy
Induction/augmentation of labour/active management
Preterm labour & delivery
Oxytocics, tocolytics & prostaglandins
Intrauterine death
PDPH
Maternal mortality

6 Instrumental Delivery and Third Stage
Instrumental delivery
Caesarean section (CS) - emergency (classification)
Epidural anaesthesia for Caesarean section
Spinal anaesthesia for CS
Inadequate block for CS
General anaesthesia for CS
Cricoid pressure
Difficult intubation
Awake intubation
Air embolism
Other problems during CS
Post-CS analgesia
Post-CS recovery
Retained placenta

7 The Neonate
Drugs and the neonate
Neonatal physiology
Neonatal assessment (neurobehavioural)
Neonatal CPR
Perinatal mortality

8 Anaesthetic Complications
Poor quality epidural analgesia
Bloody tap
Dural puncture
Post-dural puncture headache
Epidural blood patch
Pruritis
Shivering
Nausea and vomiting
Extensive blocks
Cranial nerve palsies/Horner's syndrome
Meningitis
Spinal abscess
Nerve injury
Cauda equina syndrome
Arachnoiditis
Backache
Awareness
Aspiration of gastric contents

SECTION 3 PUERPERIUM AND AFTER

Drugs and breastfeeding
Follow-up
Maternal satisfaction

SECTION 4 ORGANISATIONAL ASPECTS

Labour ward organisation
Minimum standards
Antenatal education
Audit
Risk management
Protocols and guidelines
Medicolegal aspects
Consent
Record keeping
OAA/SOAP
Midwives training, accountability, drugs
Research in obstetrics/ethics
Vital statistics
History
Test doses