Obstetric Anesthesia and Uncommon Disorders

456 Pages·2008·13.02 MB·English

by  David R. Gambling

ObstetricAnesthesiaandUncommonDisorders,
2ndedition
This new edition of Obstetric Anesthesia and Uncommon Disorders
providesaconvenientresourceforpractitionerssuddenlyfacedwith
aparturientwhohasanunusualmedicalorsurgicalcondition.
Thebookconsiderstheimpactofaconditiononpregnancy,labor
and delivery, or the fetus and the impact of pregnancy on a
condition, or the effect of therapy for the disorder on the fetus or
neonate.
Casereportsandexperiencefromtheworldliterature,andclinical
advicefrommanyspecialists,havebeendrawntogetherbyaninter-
nationalteamofeditorsandcontributorswhoareleadingexpertsin
thefield.Clear,concisemanagementguidelinesandalgorithmsare
provided, and each chapter is written from the viewpoint of the
obstetricanesthesiologist.
Fullyupdated,withnewchaptersonChronicpaininpregnancyand
Malignancy and pregnancy, Obstetric Anesthesia and Uncommon
Disorderscontinuestobeaninvaluableresourceforanyanesthesiol-
ogistinvolvedintheclinicalmanagementofthesecomplexpatients.
Reviewsofthefirstedition:
‘‘verywellwrittenandcomprehensive...andanexcellentvalue-for-
money textbook for all anesthesiologists interested in obstetric
anesthesia.’’ Anesthesiology
‘‘... anypractitionerofobstetricanesthesiawillfindoccasiontorefer
tothisusefulandpracticalbook.’’
InternationalJournalofObstetricAnesthesia
‘‘... covering conditions as diverse as cystic fibrosis, acute severe
asthma, rheumatoid arthritis, and transplants... it is a must for
everydeliverysuite.’’ BritishJournalofAnaesthesia
DAVID R. GAMBLING isaStaffAnesthesiologistatSharpMaryBirch
Hospital for Women, San Diego and Associate Clincal Professor of
AnesthesiologyatUniversityofCalifornia,SanDiego,USA.
M. JOANNE DOUGLAS is the Clinical Professor of Anesthesiology,
Pharmacology and Therapeutics at the University of British
Columbia,Canada.
ROBERT S.F. MCKAY is the Clinical Professor and Chair of the
DepartmentofAnesthesiologyattheUniversityofKansasSchoolof
Medicine,Wichita,USA.

Obstetric Anesthesia and
Uncommon Disorders
2nd edition
Editedby
David R. Gambling
M. Joanne Douglas
Robert S.F. McKay
CAMBRIDGEUNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo
Cambridge University Press
The Edinburgh Building, Cambridge CB2 8RU, UK
Published in the United States of America by Cambridge University Press, New York
www.cambridge.org
Information on this title: www.cambridge.org/9780521870825
© Cambridge University Press 2008
This publication is in copyright. Subject to statutory exception and to the provision of
relevant collective licensing agreements, no reproduction of any part may take place
without the written permission of Cambridge University Press.
First published in print format 2008
ISBN-13 978-0-511-38804-0 eBook (NetLibrary)
ISBN-13 978-0-521-87082-5 hardback
Cambridge University Press has no responsibility for the persistence or accuracy of urls
for external or third-party internet websites referred to in this publication, and does not
guarantee that any content on such websites is, or will remain, accurate or appropriate.
Every effort has been made in preparing this publication to provide accurate and up-to-
date information which is in accord with accepted standards and practice at the time of
publication. Although case histories are drawn from actual cases, every effort has been
made to disguise the identities of the individuals involved. Nevertheless, the authors,
editors and publishers can make no warranties that the information contained herein is
totally free from error, not least because clinical standards are constantly changing through
research and regulation. The authors, editors and publishers therefore disclaim all liability
for direct or consequential damages resulting from the use of material contained in this
publication. Readers are strongly advised to pay careful attention to information provided
by the manufacturer of any drugs or equipment that they plan to use.
CONTENTS
Listofplates pagevi 12 Chronicpaininpregnancy
Listofcontributors vii HectorJ.LacassieandHollyA.Muir 229
Preface ix
Section4 Metabolicdisorders 239
Section1 Cardiovascularandrespiratorydisorders 1
13 Disordersofintermediarymetabolism
1 Structuralheartdiseaseinpregnantwomen StephenHalpernandBhadreshShah 239
BrendanCarvalhoandEthanJackson 1
14 Liverandrenaldisease
2 Disordersofcardiacconduction M.J.PaechandK.Scott 249
JeanE.Swenerton,RavishankarAgaram,andVictorF.Huckell 29
15 Malignanthyperthermia
3 Vasculardiseases M.JoanneDouglas 269
DavidR.Gambling 57
16 Rareendocrinedisorders
4 Respiratorydisordersinpregnancy J.M.MhyreandL.S.Polley 275
JohnPhilipandShivK.Sharma 75
Section5 Otherdisorders 293
Section2 Musculoskeletaldisorders 101
17 Blooddisorders
5 Myopathies M.JoanneDouglasandPennyBallem 293
ChantalCrochetiere 101
18 Infectiousdiseasesinpregnancy
6 Parturientsofshortstature GabrielaRochaLaurettiandRobertS.F.McKay 321
AndreaJ.Fuller,SheilaE.Cohen,andEmilyF.Ratner 115
19 Dermatoses
7 Disordersofthevertebralcolumn RobertS.F.McKayandJohnE.Schlicher 343
EdwardT.Crosby 129
20 Psychiatricdisordersinpregnancy
8 Miscellaneousskeletalandconnectivetissuedisorders TimothyJ.G.Pavy 363
inpregnancy
CarolineGrange 145 21 Malignancyandpregnancy
HollyA.Muir,MichaelSmith,andDavidR.Gambling 371
Section3 Nervoussystemdisorders 167
22 Pregnancyandtransplantation
9 Disordersofthecentralnervoussysteminpregnancy
KerriM.Robertson 381
J.Martinez-TicaandR.B.Vadhera 167
23 Autoimmunediseases
10 Spinalcorddisorders
CarolineGrange 405
RoannePreston 191
Index 423
11 Peripheralneuropathy
FelicityReynolds 215
v
PLATES
Platesectionbetweenpages278and279
Figure14.1 page262
Figure17.1 296
Figure17.3 305
Figure17.4 307
Figure19.1 346
Figure19.2 349
vi
CONTRIBUTORS
RavishankarAgaram,MBBS,MD(Anes),FRCA DavidR.Gambling,MB,BS,FRCPC
SpecialistRegistrar ClinicalAssociateProfessor
DepartmentofAnaesthetics DepartmentAnesthesiology,UniversityofCalifornia,SanDiego
GlasgowRoyalInfirmary SanDiego,CA,USA
Glasgow,UK StaffAnesthesiologist,SharpMaryBirchHospitalforWomen
PennyBallem,BSc,MSc,MD,FRCPC CarolineGrange,MBBS
ClinicalProfessor ConsultantAnaesthetist
DepartmentofMedicine NuffieldDepartmentofAnaesthetics
SchoolofHematology TheJohnRadcliffeHospital
FacultyofMedicine Oxford,UK
UniversityofBritishColumbia
Vancouver,BC,Canada StephenHalpern,MD,MSc,FRCPC
Professor,DepartmentofAnesthesia
BrendanCarvalho,MB,BCh,FRCA UniversityofToronto
DepartmentofAnesthesia DirectorofObstetricalAnesthesia
StanfordUniversitySchoolofMedicine SunnybrookandWomen’sCollegeHealthSciencesCentre
Stanford,CA,USA Toronto,Ontario,Canada
SheilaE.Cohen,MB,ChB,FRCA VictorF.Huckell,MD
ProfessorofAnesthesiaandofObstetricsandGynecology ClinicalProfessorofMedicine
DepartmentofAnesthesia UniversityofBritishColumbia
StanfordUniversitySchoolofMedicine Vancouver,BC,Canada
Stanford,CA,USA
EthanJackson,MD
ChantalCrochetiere,MD,FRCPC ClinicalAssistantProfessorofCardiothoracicAnesthesia
AssistantProfessor DirectorofIntraoperativeTransesophagealEchocardiography,
UniversityofMontre´al andDivisionChiefofAdultCongenitalCardiothoracicAnesthesia
DepartmentofAnesthesiology StanfordUniversityMedicalCenterand
Sainte-JustineHospital LucillePackardChildren’sHospitalatStanfordUniversity.
CheminCoˆte-Ste-Catherine Stanford,CA,USA
Montre´alQC,Canada
HectorJ.Lacassie,MD
EdwardT.Crosby,MD,FRCPC AssociateProfessor
DepartmentofAnesthesiology AnesthesiologyDepartment
OttawaHospital–GeneralCampus PontificiaUniversidadCato´licadeChileand
Ottawa,Ontario,Canada VisitingAssociate,DukeUniversityMedicalCenter
Durham,NC,USA
M.JoanneDouglas,MD,FRCPC
DepartmentofAnesthesia GabrielaRochaLauretti,MD,PhD
BCWomen’sHospital ProfessoraAssociada(Anestesiologista)
Vancouver,Canada UniversidadedeSa˜oPaulo
FaculdadedeMedicinadeRibeira˜oPreto
AndreaJ.Fuller,MD Av.Bandeirantes
NorthernColoradoAnesthesiaProfessionalConsultants Ribeira˜oPreto-SP,Brasil
StaffPhysician
FortCollins,CO,USA J.Martinez-Tica,MD
AssociateProfessor
DepartmentofAnesthesiology
UniversityofTexasMedicalBranch
Galveston,TX,USA
vii
Listofcontributors
RobertS.F.McKay,MD FelicityReynolds,MBBS,MD,FRCA,FRCOGadeundem
ClinicalProfessorandChair EmeritusProfessorofObstetricAnaesthesia
DepartmentofAnesthesiology StThomas’sHospital
UniversityofKansasSchoolofMedicine–Wichita London,UK
Wichita,KS,USA
KerriM.Robertson,MD
J.M.Mhyre,MD AssociateClinicalProfessor
RobertWoodJohnsonClinicalScholar Chief,GVTCCMDivision
Lecturer,DepartmentofAnesthesiology Chief,LiverTransplantation
DivisionofObstetricalAnesthesiology DepartmentofAnesthesiology
DukeUniversityMedicalCenter
HollyA.Muir,MD Durham,NC,USA
ViceChairClinicalOperationsDepartmentofAnesthesiology
Chief,DivisionofWomen’sAnesthesia JohnE.Schlicher,MD,FAAD
DukeUniversityMedicalCenter PrivatePracticeDermatologist
Durham,NorthCarolina,USA BeatriceKellerClinic
SunCityWest,AZ,USA
M.J.Paech,MB
SchoolofMedicineandPharmacology K.Scott,BM,FRCA
TheUniversityofWesternAustralia SpecialistRegistrarinAnaesthesia
DepartmentofAnaesthesiaandPainMedicine OxfordRadcliffeHospitalsNHSTrust
KingEdwardMemorialHospitalforWomen Oxford,UK
Subiaco,WesternAustralia
BhadreshShah,MB,BS,MD
TimothyJ.G.Pavy,MBBS,FANZCA,FRCA,FFPMANZCA,DA,DIP, FellowinObstetricalAnesthesia
MID,COG SunnybrookandWomen’sCollegeHealthSciencesCentre
StaffSpecialistAnaesthetistandHeadofDepartment Toronto,Ontario,Canada
DepartmentofAnaesthesiaandPainMedicine
KingEdwardMemorialHospital ShivK.Sharma,MD,FRCA,Professor
Subiaco,WesternAustralia DepartmentofAnesthesiologyandPainManagement
ObstetricDivision
JohnPhilip,MD,AssociateProfessor UniversityofTexasSouthwesternMedicalCenter
DepartmentofAnesthesiologyandPainManagement Dallas,TX,USA
UniversityofTexasSouthwesternMedicalCenter
Dallas,TX,USA MichaelSmith,MD
ChiefResidentinAnesthesiology
L.S.Polley,MD DepartmentofAnesthesiology
AssociateProfessorofAnesthesiology UniversityofKansasSchoolofMedicine–Wichita
Director,ObstetricAnesthesiology Wichita,KS,USA
UniversityofMichiganHealthSystem
F3900MottChildren’sHospital JeanE.Swenerton,MD,FRCPC
AnnArbor,MI,USA ClinicalAssociateProfessor
DivisionofObstetricAnesthesia
RoannePreston,MD,FRCPC FacultyofMedicine
DepartmentofAnesthesia TheUniversityofBritishColumbia
BCWomen’sHospital Canada
Vancouver,BC,Canada
R.B.Vadhera,MD,FRCA,FFARCSI
EmilyF.Ratner,MD,DABMA Director,OBAnesthesia
AssociateProfessor DepartmentofAnesthesiology
Co-Director,DivisionofMedicalAcupuncture UniversityofTexasMedicalBranch
DepartmentofAnesthesia Galveston,TX,USA
StanfordUniversitySchoolofMedicine
Stanford,CA,USA
viii
PREFACE TO THE SECOND EDITION
It has been almost ten years since the first edition of Obstetric ThisbookisdedicatedtomywifeKimberleyandchildren
Anesthesia and Uncommon Disorders was published. Over the Carwyn,Jake,andSamantha. DavidR.Gambling
past few years colleagues have asked the editors when they
Thisbookisdedicatedtomyfamily:mymother,Bill,Matthew,
couldexpecttoseeanewedition.Wehadsomehesitation,not
Sheila,Erin,andMark,whofillmylifewithjoy.
leastofwhichwasbecausewefeltthatmanypractionerscould
M.JoanneDouglas
findmostofthisinformationforthemselvesusingtheinternetor
subspecialtyjournals.Uponreflection,werecognizedthatthere Wededicatethisbooktothemanyanesthesiologistswhowork
isnosubstituteforatextbookthatcontainsinformationgathered longhourstoprovidesafecaretomothersandbabies,andtotheir
andcarefullyreviewedbyanumberofdevotedspecialists.Hence, familieswhomakethesacrificesthatallowtheirlovedoneto
spurredonbythoserequestsforasecondeditionitwasdecided providethiscare.ThankyouSusan,Lindsey,andKatie.
to create a revision that provides more recent references and RobertS.F.McKay
reflects some of the changes in obstetric anesthesia practice
TothememoryofDrCliveMeintjiesawonderfulfriend,mentor
that have occurred over the past ten years. With the assistance
anddoctor.
ofathirdeditor,RobertS.F.McKay,werecruitedsomeoutstand-
ingnewcontributorsfromaroundtheworldandcreatedasecond
editionthatwetrustthereaderwillfinduseful.Wehavecontin-
uedtousechaptersbasedonbodysystemsanddiseases.Wehave
consolidated some chapters, split others, and added two new
chapters, namely ‘Chronic pain inpregnancy’ and ‘Malignancy
andpregnancy’.Therearenow23chapterseachillustratedwith
figures,tables,andphotographs,andeachchapterisaccompa-
niedbyacomprehensivelistofupdatedreferences.
Wethankournewpublishers,CambridgeUniversityPress,for
givingustheopportunitytoproducethisrevision,andwewould
liketothankeachandeverycontributorfortheirhardworkand
commitmenttothisproject.
Finally,wewanttothankourfamiliesfortheirpatiencewhile
wespenthours,toonumeroustocount,finetuningeachchapter.
ix