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International Journal of Obstetric Anesthesia

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https://www.readbyqxmd.com/read/28487040/immediate-postpartum-neurological-deficits-in-the-lower-extremity-a-prospective-observational-study
#1
A Richards, T McLaren, M J Paech, E A Nathan, E Beattie, N McDonnell
BACKGROUND: Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. METHODS: A prospective observational study of postpartum women delivering in a single maternity hospital during three months of 2016. Among 1147 eligible women, 1019 were screened for symptoms of lower extremity numbness or weakness within eight to 32hours of delivery...
April 8, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28487039/in-reply
#2
LETTER
B M Scavone
No abstract text is available yet for this article.
April 7, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28487038/one-patch-too-many
#3
LETTER
K Mcintosh
No abstract text is available yet for this article.
April 7, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28499551/lessons-learned-from-a-single-institution-s-retrospective-analysis-of-emergent-cesarean-delivery-following-external-cephalic-version-with-and-without-neuraxial-anesthesia
#4
A Ainsworth, H P Sviggum, M C Tolcher, A L Weaver, M A Holman, K W Arendt
OBJECTIVES: To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. BACKGROUND: Randomized trials have shown increased external cephalic version success when neuraxial anesthesia is used, without additional risk. We hypothesized that in our actual clinical practice, outside the confines of randomized trials, neuraxial anesthesia could be associated with an increased risk of emergent cesarean delivery...
April 2, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28501265/an-algorithm-for-the-management-of-coagulopathy-from-postpartum-hemorrhage-using-fibrinogen-concentrate-as-first-line-therapy
#5
S Seto, A Itakura, R Okagaki, M Suzuki, O Ishihara
BACKGROUND: We constructed an algorithm for the management of coagulopathy from massive postpartum hemorrhage. Fibrinogen concentrate was administered preferentially, and the dose of both fibrinogen concentrate and fresh frozen plasma given was determined by the plasma fibrinogen concentration and prothrombin time. The efficacy of the algorithm and the amount of fibrinogen concentrate and fresh frozen plasma transfused were determined. METHODS: The study was conducted in a single teaching perinatal center...
April 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28499552/puerperal-ventral-epidural-hematoma-after-epidural-labor-analgesia
#6
I Gruzman, I Shelef, A Y Weintraub, A Zlotnik, O Erez
Serious complications in obstetric anesthesia are a rare occurrence. High neuraxial block, respiratory arrest in labor and delivery, and an unrecognized spinal catheter are among the most frequently reported serious complications. A serious complication occurs in approximately 1:3000 obstetric patients. Neuraxial hematoma after obstetric epidural analgesia or anesthesia is extremely rare. We present a case of a puerperal spinal epidural hematoma following epidural labor analgesia. The patient presented with foot drop, which resolved after conservative treatment...
March 31, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28404439/haemodynamic-changes-during-labour-continuous-minimally-invasive-monitoring-in-20-healthy-parturients
#7
J C Kuhn, R Sørum Falk, E Langesæter
BACKGROUND: There are few studies on maternal haemodynamic changes during labour. None have used continuous cardiac output monitoring during all labour stages. In this observational study, we monitored haemodynamic variables continuously during the entire course of labour in healthy parturients. METHODS: Continuous haemodynamic monitoring with the LiDCOplus technique was performed in 20 healthy parturients during spontaneous labour, vaginal delivery and for 15minutes postpartum...
March 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28377309/abdominal-girth-vertebral-column-length-and-spread-of-intrathecal-hyperbaric-bupivacaine-in-the-term-parturient
#8
Chang-Na Wei, Yin-Fa Zhang, Feng Xia, Li-Zhong Wang, Qing-He Zhou
BACKGROUND: We aimed to test whether abdominal girth and vertebral column length were predictors of spinal hyperbaric bupivacaine spread in term parturients. METHODS: A total of 128 parturients having elective caesarean section under spinal anaesthesia were enrolled. Combined spinal-epidural anaesthesia was performed at the L3/4 interspace, confirmed by ultrasonography. Two millilitres of 0.5% hyperbaric bupivacaine was injected intrathecally and spinal spread assessed at three minute intervals...
February 27, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28385419/vital-signs-and-other-observations-used-to-detect-deterioration-in-pregnant-women-an-analysis-of-vital-sign-charts-in-consultant-led-uk-maternity-units
#9
G B Smith, R Isaacs, L Andrews, M Y K Wee, E van Teijlingen, D E Bick, V Hundley
BACKGROUND: Obstetric early warning systems are recommended for monitoring hospitalised pregnant and postnatal women. We decided to compare: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) type of chart used; and (iv) presence of explicit instructions for escalating care. METHODS: One-hundred-and-twenty obstetric early warning charts and escalation protocols were obtained from consultant-led maternity units in the UK and Channel Islands...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28372855/neuromodulation-and-obstetric-anaesthesia
#10
EDITORIAL
James Griffiths, Peter Teddy
No abstract text is available yet for this article.
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#11
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28185795/paraplegia-after-accidental-continuous-subdural-analgesia
#12
Jie Chen, Yafang Hu, Liang Lv
Almost all reported cases of unintentional subdural block have described a reversible disorder. We report a patient who developed an incomplete mixed sensory and motor neurological deficit after accidental continuous subdural infusion of 0.1% levobupivacaine given to provide postoperative analgesia after cesarean section. Our report shows that accidental continuous subdural injection can cause permanent neurological sequelae. In the event of suspected compressive neural damage, subdural fluid accumulation, although very rare, should be considered...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28185794/neuraxial-opioids-for-post-cesarean-delivery-analgesia-can-hydromorphone-replace-morphine-a-retrospective-study
#13
B Marroquin, C Feng, A Balofsky, K Edwards, A Iqbal, J Kanel, M Jackson, M Newton, D Rothstein, E Wong, R Wissler
BACKGROUND: Cesarean delivery is the most common surgical procedure performed in the USA. We evaluated the postoperative analgesic properties of neuraxial hydromorphone compared to neuraxial morphine for post-cesarean delivery analgesia. METHODS: A retrospective chart review was performed of women who underwent cesarean delivery and received neuraxial anesthesia from March to November 2011 and from March to November 2012. A total of 450 patients received intrathecal morphine 200μg and 387 patients received intrathecal hydromorphone 60μg...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28169064/prophylactic-abdominal-aorta-balloon-occlusion-during-cesarean-section
#14
LETTER
B Heidemann
No abstract text is available yet for this article.
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28139328/norepinephrine-for-maintaining-blood-pressure-during-spinal-anaesthesia-for-caesarean-section-a-12-month-review-of-individual-use
#15
LETTER
W D Ngan Kee
No abstract text is available yet for this article.
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28139327/out-of-hospital-cardiac-arrest-in-pregnancy-after-20weeks-gestation-emphasis-on-decision-making-by-emergency-physicians-responding-to-the-event
#16
LETTER
S Lemoine, D Jost, O Maurin, J P Tourtier
No abstract text is available yet for this article.
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28108077/an-asymptomatic-carrier-of-becker-s-muscular-dystrophy-with-cardiomyopathy-in-pregnancy-peripartum-or-not
#17
LETTER
A Gupta, A Hazarika, K Jain, P Sikka, V Suri
No abstract text is available yet for this article.
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#18
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28034599/neuraxial-analgesia-in-a-pregnant-woman-with-fowler-s-syndrome-and-sacral-neuromodulation
#19
M Ansó, L Veiga-Gil, J De Carlos, A Hualde, J Pérez-Cajaraville
We report the anesthetic management of a 16-year-old woman with Fowler's syndrome who became pregnant three years after sacral neuromodulation was initiated for treatment of the condition. Multidisciplinary consensus was to switch off the neurostimulator during pregnancy, and attempt vaginal delivery with a neuraxial block. When the patient was admitted for labor, an epidural catheter was placed successfully. The patient had a normal vaginal delivery. Sacral neuromodulation was restarted uneventfully in the early puerperium and the Fowler's syndrome remains well controlled...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28025008/prolonged-thoracic-epidural-analgesia-for-chest-tube-pain-during-pregnancy
#20
LETTER
M G Holmes, L A Bollag
No abstract text is available yet for this article.
May 2017: International Journal of Obstetric Anesthesia
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