The unique hormonal environment of pregnancy causes several changes to skin, hair, and nails. These changes may alter the appearance or behavior of chronic skin conditions, necessitating management changes. Additionally, the anesthesiologist may encounter several pregnancy-specific dermatologic conditions, some of which have broad implications for anesthetic management. Dermatologic drug safety in pregnancy is also a significant concern, as many of the medications commonly used outside of pregnancy are considered teratogenic. A thorough understanding of common dermatologic disease states and their implications on anesthetic management is crucial for the practitioner of obstetric anesthesia.

Cardiovascular disease (>25%) is the leading cause of death among pregnant women in the United States. This chapter covers risk stratification, pathophysiology, and anesthetic management of women with specific cardiac diseases. In the last decade, advances in treatment and management of cardiac disease in the pregnant patient have led to improvements in survival of obstetric patients with known cardiac disease. Key to the improvements in care is the creation of Pregnancy Heart Teams, multidisciplinary teams with knowledge and experience caring for the obstetric patient with cardiovascular disease. Cardiovascular disease encompasses a heterogeneous group of lesions with differing hemodynamic goals, management and risks during pregnancy, delivery, and postpartum. The anesthesiologist is best able to care for these women by understanding the specific cardiovascular lesion, a woman’s current status, the obstetric and fetal considerations and the impact of anesthetic techniques.