Archaeological Chemistry by Beck C.W. (ed.)

By Beck C.W. (ed.)

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No data demonstrate the relationship between pharyngeal volume and intubation difficulties, but it is reasonable that decreasing pharyngeal volume could become an impediment to intubation. A decreased pharyngeal volume after labor assumes great importance in parturients who have Mallampati class 4 at the beginning of labor. Therefore, it is prudent to insert an epidural catheter in those parturients with a complicated labor, and it is essential to carefully reevaluate the upper airways in laboring women presenting for urgent or emergent cesarean delivery just before the commencement of anesthesia rather than obtaining this information from prelabor data, especially if there are factors increasing the risk of difficult intubation like short neck, receding mandible, protruding maxillary incisors, and morbid obesity [57, 58].

Williams KP, Wilson S (1999) Evaluation of cerebral perfusion pressure changes in laboring women: effects of epidural anesthesia. Ultrasound Obstet Gynecol 14:393–396 16. Juppila R, Hollmen A (1976) The effect of segmental epidural analgesia on maternal and foetal acid-base balance, lactate, serum potassium and creatine phosphokinase during labor. Acta Anesthesiol Scand 20:259–268 17. Reed PN, Colquhoun AD, Hanning CD (1989) Maternal oxygenation during normal labour. Br J Anaesth 62:316 18. Mu¨ller G, Huber JC, Salzer H et al (1984) Maternal hyperventilation as a possible cause of fetal tachycardia sub partu.

In addition, efferent nerve fibers travel from the spinal cord via the hypogastric plexus to modulate smooth muscle activity in the cervix [7–10]. The parasympathetic supply to the uterus is from the second, third, and fourth sacral segments, collectively known as the pudendal nerve [4]. As pregnancy progresses, the nerve supply to the uterus undergoes extensive changes. The corpus uteri becomes progressively denervated as the gravid uterus increases in size, but the dense network of nerves from the hypogastric plexus to the cervix remains unchanged.

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