1. Most drugs (opioids, local anesthetics, inhaled anesthetics) readily cross the placenta (Table 40-2: Determinants of Drug Passage Across the Placenta).
2. Fetus and Newborn. Several characteristics of the fetal circulation delay equilibration between fetal arterial and venous blood and thus delay the onset or magnitude of depressant effects of anesthetic drugs (Table 40-3: Characteristics of Fetal Circulation that Delay Drug Equilibration).
   1. Neurobehavioral studies in neonates born in the presence of epidural anesthesia may reveal subtle changes in newborn neurologic and adaptive function.
   2. These changes are minor and transient, lasting only 24 to 48 hours.

Obstetrical Anesthesia

1. Physiologic Changes of Pregnancy
2. Placental Transfer and Fetal Exposure to Anesthetic Drugs
3. Anesthesia for Labor and Vaginal Delivery
4. Anesthesia for Cesarean Delivery
5. Anesthetic Complications
6. Management of High-Risk Parturients
7. Preterm Delivery
8. Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome
9. Substance Abuse
10. Fetal Monitoring
11. Newborn Resuscitation in the Delivery Room
12. Anesthesia for Nonobstetric Surgery in Pregnant Women