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 Bucklin entitled “Gerard W. Ostheimer ‘what’s new in obstetric anesthesia’ lecture” on page 865 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: http://www.asahq.org/journal-cme. 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 this article, participants should have a better understanding of some of the latest developments in obstetric anesthesia.

Author – Brenda A. Bucklin, M.D.

Grants or research support:  None

Consultantships or honoraria:  None

The article authored by Dr. Bucklin 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 Bucklin entitled “Gerard W. Ostheimer ‘what’s new in obstetric anesthesia’ lecture”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=104&issue=4&page=865∂=fulltextin the April issue of Anesthesiology, choose the one correct answer for each question:

1. Which of the following is least  likely to be a leading cause of maternal death due to cardiac disease?

A. Spontaneous coronary artery dissection

B. Peripartum cardiomyopathy

C. Myocardial infarction

D. Aortic dissection

2. Which one of the following statements concerning cardiomyopathy and pregnancy is most  likely true?

A. Cardiomyopathy rarely leads to maternal death.

B. Beta-adrenergic blockade is contraindicated.

C. Dilated cardiomyopathy carries a greater risk of death compared to hypertrophic cardiomyopathy.

D. Atrial fibrillation is usually well tolerated.

3. Which of the following statements concerning pulmonary hypertension in pregnancy is most  likely true

A. It is associated with a low mortality.

B. Inhaled prostacyclin therapy is not as effective as intravenous therapy.

C. Intravenous prostacyclin therapy can impair platelet function.

D. Inhaled prostacyclin therapy impairs platelet function to the same degree as intravenous prostacyclin therapy.

4. Which one of the following statements concerning magnesium sulfate therapy in preeclampsia and eclampsia is most  likely true

A. It is no longer the mainstay of seizure prophylaxis.

B. It results in a same rate of recurrent seizures compared to diazepam.

C. Its use is not associated with maternal respiratory depression.

D. Its use is not associated with reduced perinatal mortality.

5. Which of the following is least  likely to explain the reduction in anesthesia-related maternal deaths since the 1980s

A. A decrease in the cesarean section rate

B. Greater use of regional anesthesia

C. An increase in the administration of aspiration prophylaxis

D. Improved airway management

6. Which one of the following is most  likely true concerning neuraxial analgesia/anesthesia in obstetric patients

A. Injuries are more common after epidural anesthesia compared to spinal anesthesia.

B. Serious complications from neuraxial blocks are more common in obstetric compared to nonobstetric patients.

C. The most common complication in the Closed Claims Database of the American Society of Anesthesiologists is inadequate anesthesia.

D. Spinal hematomas only occur in patients with apparent signs of coagulopathy.

7. Which of the following statements is most  likely true concerning neurologic injury after neuraxial blockade in obstetric patients

A. Back pain has great specificity.

B. Central neurologic injuries are associated with weakness of the paraspinous muscles and a sensory deficit in the lower back.

C. Central neurologic injuries are best diagnosed by computed tomography scan.

D. The cause of peripheral neurologic injury is best established by electromyography.