Wa0003.
Wa0003.
Wa0003.
mucosal layer
2) Inc tissue friability
3)Risk-obstruction and bleeding
(inteumentation).
4) Take care during
suction,Intubation, Ryles tube
AIRWAY
After 20 wks
1)Enlarged uterus 1) Non particulate oral Antacid
2)Stomach & pylorus- cephalad (3O ml sodium citrate)
displacement and increased 2)I/V- H2 receptor blocker ( Inc ph
intragastric pressure in 1 hour.
3) Reposition of intra- abdominal 3) I/V Metclopramide- Inc gastric
oesophagus emptying.
ASPIRATION 4) Inc Estrogen and progesterone
Treat as a full stomach
CVS
Labour - 10-25 % Inc in 1st stage
- 40 % Inc in 2nd stage
PHYSIOLOGICAL
lead 3.
DR ANKUSH MALHOTRA
CHANGES OF 1)Heart displaced LT and anterior
2) RT side chamber Inc 20 % MD ANAESTHESIA
2D ECHO
PREGNANCY
3) LT side chamber Inc by 10-12 %
4) E/F Inc - Lt vent eccentric Contact- +91 9041817291
hypertrophy
+91 7986414239
Reason-
Mainly by inc TV
MV inc by 50% 1) progesterone
Minimal by RR
2) Inc CO2 production
ABG-
1)PH -7.42-7.44,
ANAESTHESIA
2)PCO2 - 30
Due inc renal excretion of bicarbonate ions.
3)PO2 inc 100 mm Hg initially
BLUEPRINT
due to hyperventilation & dec. PCO2
4)Then dec later trimester due Airway closure Ref- MILLERS
and associated intrapulmonary shunting
RESP
1)RT Shift of ODC
2)P50 inc from 27 to. 30 mm Hg
3)Oxygen consumption increased
by 20% @ term, 40% @1st stage,
75% @ 2nd stage
LUNG VOL -
1)FRC dec by 20 % - causes early 1) Dec FRC (Dec Oxygen reserves)
airway closing ( ATELECTASIS) 2) Inc O2 consumption
2) TLC dec 0-5 % 3) Aortocaval compression - Dec Preoxygenation with 100% O2,
APNEA - Rapid desaturation
2) VC, FEV1, FEV1/FVC, closing venous return - dec CO - Inc for 3 minutes- Mandatory
capacity - no change oxygen extraction- decreased
3) Rapid inhalation induction & PO2 in venous blood
emergence
@Term Decreased
1) RBF 1)BUN Return to normal 3 month
RENAL 2) GFR 2) S. creatinine postpartum
Both Inc by 50-60 % By 5O% of prepregnancy value
Intravascular volume
Anaemia of increases 1000 -1500 ml
HAEMATOLOGY pregnancy Plasma volume inc 50%
RBCs vol inc 25 %