A 29-year-old woman, para 1041, was admitted from the prenatal center in the 13th week of gestation, with the diagnosis of incompetent cervix.
Past gynecologic history included a normal spontaneous vaginal delivery 10 years ago, two elective terminations of pregnancy under general anesthesia, and two subsequent spontaneous abortions. During the first pregnancy, she had mild hypertension that was not treated.
This pregnancy was uncomplicated except for mild nausea and vomiting in the 2nd month. Weight gain was normal. The patient complained of mild dyspnea after climbing two flights of stairs. She denied back pain or other neuromuscular disorders, easy bruis ability, or bleeding. The patient’s last oral intake was breakfast 7 hours earlier.
Physical examination was normal; the chest was clear; there were no murmurs. Blood studies from the prenatal center included hematocrit 33%, platelets 220,000, and glucose 68 mg/dl.
The patient was scheduled for a McDonald procedure. During the preanesthesia assessment, she inquired as to which anesthetic technique had the least risk of affecting the baby.
KeywordsObstet Gynecol Spontaneous Abortion Folinic Acid Cervical Cerclage Postdural Puncture Headache
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