Maternal Physiologic Changes Of Pregnancy Implications For Anesthesia Jeopardy Template

Respiratory Changes	Cardiovascular/Hematologic Changes	Gastrointestinal Changes	Renal/Hepatic Changes	Nervous System Changes
100 Decreased; due to diaphgragm elevation from gravid uterus What happens to FRC in pregnancy and why?	100 Increased by 40-50% at term What happens to plasma volume during pregnancy?	100 Decreased; due to mechanical effects of the gravid uterus and progesterone direct effect on LES tone What happens to LES tone in pregnancy? Why?	100 Increased by ~50% by first trimester What happens to GFR during pregnancy? Which trimester is this achieved by?	100 Decreased; due to progesterone and estrogen effects on CNS How does pregnancy affect MAC for inhaled anesthetics? Why?
200 Increased; due to progesterone effects on respiratory center How does minute ventilation change during pregnancy? Why?	200 Gravid uterus compressing great vessels when supine, possibly leading to hypotension What is meant by aortocaval compression in the setting of pregnancy?	200 Normal during pregnancy; Delayed during labor How is gastric emptying affected during pregnancy and labor?	200 < 0.8 mg/dL What is the normal serum creatinine in pregnancy?	200 Decreases due to engorged epidural veins How does the epidural space change in pregnancy? What are the anesthetic implications?
300 Mild respiratory alkalosis What acid-base finding is normal in pregnancy?	300 Dilutional anemia from increased plasma volume relative to RBC mass What is physiologic anemia of pregnancy?	300 Rapid sequence induction due to aspiration risk and rapid desaturation What is the preferred induction method in obstetric general anesthesia? Why?	300 Alkaline phosphatase Which liver enzyme is normally elevated due to placental production?	300 Decreased due to increased sensitivity to local anesthetics as well as reduced CSF volume How do we adjust the dosage of neuraxial (spinal) local anesthetics for pregnant patients?
400 Difficult airway; friable mucosa, edema; narrowed glottic opening How does the pregnant airway differ from preconception?	400 Can reach up to 600 mg/dL What is the normal fibrinogen in pregnant patients?	400 Sodium citrate (Bicitra) What is the most popular non-particulate antacid used before a C-section?	400 Biliary stasis; due to progesterone effects on gallbladder contractility What happens to the biliary tree in pregnancy? Why?	400 Rate of rise increases; greater speed of induction with volatile anesthetics How does Fa/Fi change in pregnancy? What is the anesthetic implication
500 Up to 2 weeks after delivery When does FRC return to preconception values?	500 Fibrinogen, VII, VIII, IX, X, XII Which clotting factors are increased in pregnancy?	500 1st trimester: 10% 2nd trimester: 40% 3rd trimester: 55% What is the incidence of GERD in pregnancy? How does it change per trimester?	500 Expected glycosuria due to decreased capacity of the proximal tubule for resorption What happens to glucose excretion in pregnancy? Why?	500 15% in first trimester up to 23% in third trimester What is the incidence of restless legs syndrome in pregnancy?

Maternal Physiologic Changes of Pregnancy: Implications for Anesthesia

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