Anesthesiology’s journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:

  1. Read the article by Tsen entitled “Gerard W. Ostheimer ‘What’s New in Obstetric Anesthesia’ Lecture” on page 672 of this issue.

  2. Review the questions and other required information for CME program completion (published in both the print and online journal).

  3. When ready, go to the CME Web site: Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.

The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA’s Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.

Purpose:  The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.

Target Audience:  Physicians and other medical professionals whose medical specialty is the practice of anesthesia.

Learning Objectives:  After reading the article related to this program, participants should be familiar with advances in obstetric anesthesia in the topics reviewed.

Disclosure Information:

Authors – Lawrence C. Tsen, M.D.

Grants or research support:  None

Consultantships or honoraria:  None

The article authored by Dr. Tsen was supported solely from institutional and/or departmental sources.

Question Writer – Peter L. Bailey, M.D. Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.

Based on the article by Tsen entitled “Gerard W. Ostheimer ‘What’s New in Obstetric Anesthesia’ Lecture” the March issue of Anesthesiology, choose the one correct answer for each question:

1. Which of the following statements concerning preeclampsia is most  likely true?

A. The etiology of preeclampsia is well understood.

B. Aspirin prophylaxis increases the incidence of perinatal death.

C. Autoregulation of cerebral blood flow remains intact until the very late stages of preeclampsia.

D. Isosorbide dinitrate significantly impairs cerebral blood flow autoregulation in preeclamptic patients.

2. Which of the following statements concerning the management of preeclamptic patients is most  likely true?

A. Magnesium is the drug of choice for seizure prevention.

B. The goal of blood pressure control should be to achieve normal values.

C. Spinal anesthesia for cesarean delivery is contraindicated.

D. Mortality after general anesthesia for cesarean delivery is lower than after neuraxial anesthesia.

3. Intravenous corticosteroids in patients with the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) have been reported to result in all of the following except 

A. a reduction in the clinical expression of the syndrome.

B. improved recovery from HELLP.

C. exacerbation of high blood pressure.

D. improved platelet count.

4. Which of the following statements concerning management strategies for hemorrhage in the obstetric patients is most  likely true?

A. Preoperative autologous donation should start one week prior to anticipated delivery.

B. Acute normovolemic hemodilution does not have a role.

C. Intraoperative blood salvage should be routinely employed during cesarean section.

D. A Sengstaken-Blakemore tube, placed in the uterus, can prevent the need for hysterectomy.

5. Which of the following statements concerning informed consent in obstetric patients is most  likely true?

A. It is widely agreed upon that true informed consent is not possible in a laboring patient.

B. The informed consent process should be viewed as a tool to foster a better patient–physician relationship.

C. The use of a separate consent form for anesthesia is widespread.

D. In general, the perception of patients is that anesthesia is associated with significant risks.