Anaes Vivas · Obstetric physiology
Maternal physiology — Viva
Clinical viva on term physiology — rapid desaturation, aortocaval compression, spinal hypotension, and arrest readiness.
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Viva Stems
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Why does the term parturient desaturate so fast? Low oxygen store with high consumption shortens safe apnoea; general anaesthesia is a key obstetric-arrest setting needing adapted protocols and simulation.[1]
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Why is she hypotensive supine, and what is the evidence for displacement? Aortocaval compression cuts venous return from mid-pregnancy — displace left. Lumbar wedge cut hypotension in multiples (70.4 vs 86.8 percent, RR 0.8).[2]
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How do spinal haemodynamics differ between normotensive and hypertensive parturients? Normotensives appear more hypotension-prone after block; hypertensives show altered reactivity — heterogeneous review, no quantitative synthesis.[3]
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What does massive haemorrhage add to this physiology? A key perioperative haemodynamic stressor on top of block and aortocaval shifts — resuscitate early with fibrinogen-aware massive-haemorrhage protocol.[3]
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What airway preparation does term physiology demand? Mucosal engorgement and aspiration risk from mid-pregnancy — preoxygenate, plan rapid sequence, have the failed-intubation drill ready.[1]
References3ShowHide
- [1]Carvalho B, et al. Perioperative cardiac arrest in obstetric patients Curr Opin Anaesthesiol, 2026.PMID 41850587
- [2]Kim JN, et al. Effectiveness of lumbar wedge in preventing intraoperative hypotension during cesarean delivery in multiple gestation: a retrospective analysis BMC Pregnancy Childbirth, 2025.PMID 41350653
- [3]Zagrodnik E, et al. Hemodynamic Changes During Cesarean Section Under Spinal Anesthesia in Normotensive and Hypertensive Pregnant Women-A Narrative Review J Clin Med, 2026.PMID 41899085