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Pt. I Introduction
1 The History of Obstetric Anesthesia 3
Pt. II Maternal and Fetal Physiology
2 Physiologic Changes of Pregnancy 17
3 Uteroplacental Blood Flow 43
4 The Placenta: Anatomy, Physiology, and Transfer of Drugs 57
5 Fetal Physiology 75
Pt. III Fetal and Neonatal Assessment and Therapy
6 Antepartum Fetal Assessment and Therapy 91
7 Anesthesia for Fetal Surgery 110
8 Intrapartum Fetal Assessment and Therapy 122
9 Neonatal Assessment and Resuscitation 135
10 Fetal and Neonatal Neurologic Injury 163
Pt. IV Foundations in Obstetric Anesthesia
11 Spinal, Epidural, and Caudal Anesthesia: Anatomy, Physiology, and Technique 187
12 Local Anesthetics 209
Pt. V Anesthesia Before and During Pregnancy
13 Nonanesthetic Drugs During Pregnancy and Lactation 235
14 In Vitro Fertilization and Other Assisted Reproductive Techniques 249
15 Problems of Early Pregnancy 263
16 Nonobstetric Surgery During Pregnancy 279
Pt. VI Labor and Vaginal Delivery
17 Obstetric Management of Labor and Vaginal Delivery 303
18 The Pain of Childbirth and Its Effect on the Mother and Fetus 320
19 Childbirth Preparation and Nonpharmacologic Analgesia 336
20 Systemic Analgesia: Parenteral and Inhalational Agents 346
21 Epidural and Spinal Analgesia/Anesthesia 360
Sect. I Local Anesthetic Techniques 360
Sect. II Opioid Techniques 386
Sect. III Effect on the Progress of Labor and Method of Delivery 408
22 Alternative Regional Anesthetic Techniques: Paracervical Block, Lumbar Sympathetic Block, Pudendal Block, and Perineal Infiltration 427
23 Vaginal Birth After Cesarean Section 438
24 Postpartum Tubal Sterilization 449
Pt. VII Cesarean Section
25 Anesthesia for Cesarean Section 465
26 Anesthesia for Fetal Distress 493
27 Postoperative Analgesia: Systemic Techniques 509
28 Postoperative Analgesia: Epidural and Spinal Techniques 521
Pt. VIII Anesthetic Complications
29 Medicolegal Issues in Obstetric Anesthesia 559
30 Aspiration: Risk, Prophylaxis, and Treatment 578
31 The Difficult Airway: Risk, Prophylaxis, and Management 590
32 Postpartum Headache 621
33 Neurologic Complications of Labor, Delivery, and Regional Anesthesia 639
Pt. IX Obstetric Complications
34 Preterm Labor and Delivery 665
35 Abnormal Presentation and Multiple Gestation 694
36 Fever and Infection 711
37 Antepartum and Postpartum Hemorrhage 725
38 Embolic Disorders 749
Pt. X The Parturient with Systemic Disease
39 Autoimmune Disorders 765
40 Cardiovascular Disease 776
41 Endocrine Disorders 809
42 Hematologic and Coagulation Disorders 842
43 Human Immunodeficiency Virus 860
44 Hypertensive Disorders 875
45 Liver Disease 921
46 Malignant Hyperthermia 932
47 Musculoskeletal Disorders 944
48 Neurologic and Neuromuscular Disease 963
49 Obesity 986
50 Renal Disease 1000
51 Respiratory Disease 1011
52 Substance Abuse 1027
53 Trauma 1041
App. A American Society of Anesthesiologists Guidelines for Regional Anesthesia in Obstetrics 1051
App. B Practice Guidelines for Obstetrical Anesthesia: A Report by the American Society of Anesthesiologists Task Force on Obstetrical Anesthesia 1053