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Congenital adrenal hyperplasia (CAH) refers to a group of autosomal recessive disorders of adrenal steroidogenesis, the most common of which is 21-hydroxylase deficiency. This results in impaired glucocorticoid and, less frequently, mineralocorticoid production, as well as androgen excess. Strategies for medical management that is safe for both mother and fetus will be presented. The anesthetic management of labor and delivery as well as operative deliveries will be discussed.

Hyperosmolar hyperglycemic state (HHS) is a serious complication of diabetes characterized by serum hyperglycemia and hyperosmolarity, without ketoacidosis. Strategies for medical management that are safe for both mother and fetus will be presented. The anesthetic management of labor and delivery as well as operative deliveries will be discussed.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is defined as serum hyponatremia and hypoosmolality resulting from inappropriately high levels of vasopressin, also known as antidiuretic hormone (ADH), which results in impaired water excretion. Strategies for medical management that is safe for both mother and fetus will be presented. The anesthetic management of labor and delivery as well as operative deliveries will be discussed.

BACKGROUND Postoperative residual curarisationf is a preventable cause of postoperative morbidity. Although sugammadex has been shown to reduce the risk of residual curarisation, it has not yet been shown if this directly translates to a reduction in morbidity. We aimed to demonstrate whether the introduction of unrestricted sugammadex for routine reversal changed the incidence of post-operative respiratory diagnoses and the rate of airway and respiratory complications in the post-operative care unit. METHODS A historical cohort study of 1257 patients who underwent general surgical or ear, nose and throat (ENT) procedures before and after the introduction of unrestricted availability of sugammadex. Patient records were used to identify the incidence of postoperative in-hospital respiratory diagnoses and of airway complications in PACU, the pattern of muscle relaxant use and the relative costs associated with the routine availability of sugammadex. RESULTS Unrestricted sugammadex availability was associated with a significant reduction in the rate of a postoperative in-hospital respiratory diagnosis; Odds Ratio (OR) = 0.20 (95%CI 0.05-0.72, p=0.01). Furthermore, the use of sugammadex itself was also associated with a reduction in inhospital respiratory diagnoses; OR = 0.26 (95%CI 0.08-0.94, p=0.04). Unrestricted sugammadex was also associated with a decrease in the need for manual airway support in the recovery room (3.2% vs 1.1%, p=0.02) and a decrease in patients being transferred intubated to ICU (5.5% vs 1.3%, p