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https://www.readbyqxmd.com/read/29866238/amniotic-fluid-embolism
#1
Nadia Nawaz, Ahmed Raheem Buksh
Amniotic fluid embolism is a rare and severe problem in obstetric patients. We experienced a 21-year primigravida who underwent emergency cesarean section due to sudden collapse and fetal distress after rupture of membranes in labour. Subsequently, she developed intraoperative coagulopathy, hemorrhage, hypotension, and respiratory collapse requiring ventilation. Both maternal and neonatal lives were saved with full recovery and discharged in stable condition. The clinical diagnosis of amniotic fluid embolism (AFE) was made, which is a very rare complication of pregnancy/puerperium with varying presentation, ranging from cardiac arrest, circulatory collapse and death through mild degrees of organ system dysfunction with or without coagulopathy...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29788801/perioperative-noninvasive-cardiac-output-monitoring-in-parturients-with-singleton-and-twin-pregnancies-undergoing-caesarean-section-under-spinal-anesthesia-with-prophylactic-phenylephrine-drip-a-prospective-observational-cohort-study
#2
S Orbach-Zinger, E Razinsky, I Bizman, S Firman, R Gat, A Davis, E Ashwal, A Shmueli, M Vaturi, R Gabbay-Benziv, L A Eidelman
INTRODUCTION: Spinal anesthesia is considered the gold standard anesthetic technique for cesarean deliveries (CD) but is associated with a high rate of hypotension. The recent international consensus recommends continuous prophylactic phenylephrine infusion (PPI) administered throughout CD to prevent hypotension. However little information is available on the hemodynamic profiles of women with twin pregnancies as compared to singleton pregnancies perioperatively. Therefore, in this study we aim we compare maternal hemodynamic changes both intraoperatively and postoperatively with the use of the NICAS bio impendence monitor in healthy singleton versus twin parturients undergoing CD deliveries with spinal anesthesia with PPI...
May 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#3
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29765296/peripartum-haemorrhage-haemostatic-aspects-of-the-new-german-pph-guideline
#4
REVIEW
Heiko Lier, Christian von Heymann, Wolfgang Korte, Dietmar Schlembach
Summary Peripartum haemorrhage remains one of the main causes of maternal mortality world-wide. The German, Austrian and Swiss Societies of Gynaecology and Obstetrics have updated the current guidelines for the treatment of peripartum haemorrhage together with the German Society of Anaesthesiology and Intensive Care Medicine and the Society of Thrombosis and Haemostasis Research. The recommendations have been the result of a thorough review of the available scientific literature and a consensus process involving all members of the guideline group...
April 2018: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/29728756/postoperative-renal-function-in-parturients-with-severe-preeclampsia-who-underwent-cesarean-delivery-a-retrospective-observational-study
#5
Yusuke Mazda, Motoshi Tanaka, Katsuo Terui, Sayuri Nagashima, Rie Inoue
Although postoperative renal dysfunction is relatively rare after cesarean delivery, preeclampsia is considered as the high-risk population. On the other hand, hydroxyethyl starch (HES) administration for preventing maternal hypotension induced by spinal anesthesia for cesarean delivery is a common practice. However, the effect of HES administration during cesarean delivery on postoperative kidney function in parturients with severe preeclampsia is not well investigated. We retrospectively reviewed both medical and anesthesia records of patients with severe preeclampsia who underwent cesarean delivery from January 2011 to December 2013...
May 4, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29683007/perioperative-noninvasive-cardiac-output-monitoring-in-parturients-undergoing-cesarean-delivery-with-spinal-anesthesia-and-prophylactic-phenylephrine-drip-a-prospective-observational-cohort-study
#6
Sharon Orbach-Zinger, Ilya Bizman, Shlomo Firman, Shaul Lev, Roi Gat, Eran Ashwal, Mordehay Vaturi, Eitan Razinski, Atara Davis, Anat Shmueli, Leonid A Eidelman
INTRODUCTION: Spinal anesthesia for cesarean delivery is associated with high incidence of hypotension and is most often prevented by a prophylactic phenylephrine infusion (PPI). In this study, we aimed to identify maternal hemodynamic changes both intraoperatively and postoperatively with the use of the NICaS noninvasive cardiac output monitor in healthy singleton parturients undergoing cesarean delivery (CD) with spinal anesthesia and PPI. METHODS: Healthy term women undergoing spinal anesthesia for singleton CD were enrolled...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29657082/horner-s-syndrome-following-obstetric-neuraxial-blockade-a-systematic-review-of-the-literature
#7
D J Chambers, K Bhatia
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. Anaesthetic technique, clinical features, anaesthetic management of the Horner's syndrome and time to resolution were assessed...
March 17, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29628561/norepinephrine-versus-ephedrine-to-maintain-arterial-blood-pressure-during-spinal-anesthesia-for-cesarean-delivery-a-prospective-double-blinded-trial
#8
Ali Mohamed Ali Elnabtity, Mohamed Foad Selim
Background: Ephedrine was conventionally regarded as the first-choice drug to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, due to its stimulant activity on α- and β-adrenergic receptors. Norepinephrine is a weak β-adrenergic and potent α-adrenergic receptor agonist. Therefore, it may be suitable for maintaining blood pressure with less chronotropic effects compared to ephedrine. Patients and Methods: One hundred and forty healthy patients having cesarean delivery under spinal anesthesia were randomized to Group N ( n = 61) who received a prophylactic bolus of norepinephrine 5 μg intravenous (i...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29520867/randomised-double-blind-comparison-of-bolus-phenylephrine-or-ephedrine-for-treatment-of-hypotension-in-women-with-pre-eclampsia-undergoing-caesarean-section
#9
M Mohta, S Duggal, G T Chilkoti
Treatment of post-spinal hypotension during caesarean section assumes special concern in pre-eclamptic patients due to a compromised fetoplacental circulation and increased risk of placental hypoperfusion. Phenylephrine and ephedrine are the most commonly used vasopressors, although the best choice is still not clear. We studied 80 pre-eclamptic women with a singleton pregnancy who underwent caesarean section with spinal anaesthesia, and who developed hypotension defined as a decrease in systolic arterial pressure ≥ 20% from baseline or absolute value < 100 mmHg...
March 9, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29516705/comparison-of-the-effects-of-low-doses-of-dexmedetomidine-and-remifentanil-on-the-maternal-haemodynamic-changes-during-caesarean-delivery-in-patients-with-severe-preeclampsia-a-randomised-trial
#10
Mohamed R El-Tahan, Samah El Kenany, Ehsan M Abdelaty, Eiad A Ramzy
BACKGROUND: Preoperative remifentanil administration blunts haemodynamic responses to tracheal intubation in parturients with severe preeclampsia. We hypothesised that the preoperative administration of low doses of remifentanil or dexmedetomidine would lead to comparable maternal neurohormonal responses and neonatal outcomes in patients with severe preeclampsia. METHODS: Parturients diagnosed with severe preeclampsia undergoing caesarean delivery were randomly allocated to receive remifentanil (0...
March 7, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29461392/combined-colloid-preload-and-crystalloid-coload-versus-crystalloid-coload-during-spinal-anesthesia-for-cesarean-delivery-a-randomized-controlled-trial
#11
Mohamed Mohamed Tawfik, Amany Ismail Tarbay, Ahmed Mohamed Elaidy, Karim Ali Awad, Hanaa Mohamed Ezz, Mohamed Ahmed Tolba
BACKGROUND: The optimal strategy of fluid administration during spinal anesthesia for cesarean delivery is still unclear. Ultrasonography of the inferior vena cava (IVC) has been recently used to assess the volume status and predict fluid responsiveness. In this double-blind, randomized controlled study, we compared maternal hemodynamics using a combination of 500-mL colloid preload and 500-mL crystalloid coload versus 1000-mL crystalloid coload. We assessed the IVC at baseline and at subsequent time points after spinal anesthesia...
February 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29457115/comparison-of-inflationary-non-invasive-blood-pressure-inibp-monitoring-technology-and-conventional-deflationary-non-invasive-blood-pressure-dnibp-measurement-in-detecting-hypotension-during-cesarean-section
#12
Akiko Yamashita, Shingo Irikoma
Background: The Nihon Kohden linear inflationary non-invasive blood pressure (iNIBP) monitoring technology is an oscillometric device that measures blood pressure by detecting oscillations during inflation. Systolic blood pressure can be recorded without overinflating the cuff higher than the true systolic pressure. Thus, total time taken for inflation and deflation is shorter than that by the conventional deflation devices. In this study, the ability of iNIBP to detect maternal hypotension during cesarean section faster than deflationary non-invasive blood pressure (dNIBP) monitoring devices under clinical settings was evaluated prospectively...
2018: JA Clinical Reports
https://www.readbyqxmd.com/read/29416149/maternal-and-anaesthesia-related-risk-factors-and-incidence-of-spinal-anaesthesia-induced-hypotension-in-elective-caesarean-section-a-multinomial-logistic-regression
#13
Atousa Fakherpour, Haleh Ghaem, Zeinabsadat Fattahi, Samaneh Zaree
Background and Aims: Although spinal anaesthesia (SA) is nowadays the preferred anaesthesia technique for caesarean section (CS), it is associated with considerable haemodynamic effects, such as maternal hypotension. This study aimed to evaluate a wide range of variables (related to parturient and anaesthesia techniques) associated with the incidence of different degrees of SA-induced hypotension during elective CS. Methods: This prospective study was conducted on 511 mother-infant pairs, in which the mother underwent elective CS under SA...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29415779/severe-bicuspid-aortic-stenosis-in-pregnancy-balancing-the-risk-of-prematurity-and-maternal-mortality
#14
Chinedu Nwabuobi, Megan McDowell, Sarah Običan
We report a case of combined severe aortic stenosis and regurgitation in a pregnant patient with a history of congenital bicuspid aortic valve. The patient presented at 22 weeks of gestation with angina and pre-syncopal symptoms. During her admission, she experienced intermittent episodes of non-sustained ventricular tachycardia and hypotension. A multi-disciplinary healthcare team was assembled to decide on the appropriate medical and surgical treatment options. At 28 weeks of gestation, the patient underwent a caesarean delivery immediately followed by a mechanical aortic valve replacement...
May 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29406172/the-impact-of-neuraxial-clonidine-on-postoperative-analgesia-and-perioperative-adverse-effects-in-women-having-elective-caesarean-section-a-systematic-review-and-meta-analysis
#15
REVIEW
T K Allen, B M Mishriky, R Y Klinger, A S Habib
Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review and meta-analysis aims to evaluate the effect of perioperative neuraxial clonidine on postoperative analgesia in women having Caesarean section under neuraxial anaesthesia. We included randomized controlled trials comparing the analgesic efficacy of the perioperative administration of neuraxial clonidine alone or in combination with a local anaesthetic and/or opioids in women having elective Caesarean section under neuraxial anaesthesia when compared with placebo...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29398754/the-effect-of-prophylactic-infusion-of-combined-ephedrin-and-phenylephrine-on-maternal-hemodynamic-after-spinal-anesthesia-for-cesarean-section-a-randomized-clinical-trial
#16
Simin Atashkhoie, Hojat Pourfathi, Bahman Naghipour, Shahla Meshgi
Several techniques have been proposed to prevent hypotension in obstetric patients. Ephedrine and phenylephrine are individually used to prevent maternal hypotension; however, each has its own drawbacks. Some researchers have reported that the infusion of combined ephedrine and phenylephrine immediately after spinal anesthesia for cesarean delivery reduces the incidence of maternal hypotension. Other studies have indicated that the combination is not superior to the infusion of an individual agent. The present study aimed to evaluate the effect of prophylactic infusion of ephedrine and phenylephrine before the induction of spinal anesthesia for cesarean section on maternal hemodynamic...
January 2018: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29373334/comparison-of-double-intravenous-vasopressor-automated-system-using-nexfin-versus-manual-vasopressor-bolus-administration-for-maintenance-of-haemodynamic-stability-during-spinal-anaesthesia-for-caesarean-delivery-a-randomised-double-blind-controlled-trial
#17
Ban Leong Sng, Wei Du, Man Xin Lee, Farida Ithnin, Deepak Mathur, Wan Ling Leong, Rehena Sultana, Nian-Lin R Han, Alex Tiong Heng Sia
BACKGROUND: Hypotension is a common side effect of spinal anaesthesia during caesarean delivery and is associated with maternal and foetal adverse effects. We developed an updated double intravenous vasopressor automated (DIVA) system that administers phenylephrine or ephedrine based on continuous noninvasive haemodynamic monitoring using the Nexfin device. OBJECTIVE: The aim of our present study is to compare the performance and reliability of the DIVA system against Manual Vasopressor Bolus administration...
May 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29334907/hemodynamic-effects-of-lateral-tilt-before-and-after-spinal-anesthesia-during-cesarean-delivery-an-observational-study
#18
Ahmed Hasanin, Remoon Soryal, Tarek Kaddah, Sabah Abdel Raouf, Yaser Abdelwahab, Khaled Elshafaei, Mohamed Elsayad, Bassant Abdelhamid, Reham Fouad, Doaa Mahmoud, Yasmin Hassabelnaby
BACKGROUND: Post-spinal hypotension is a common maternal complication during cesarean delivery. Aortocaval compression by the gravid uterus has been assumed as a precipitating factor for post-spinal hypotension. The role of left lateral tilting position in improving maternal cardiac output after subarachnoid block (SAB) is unclear. The aim of this work is to investigate the effect of left lateral tilting on maternal hemodynamics after SAB. METHODS: A prospective observational study was conducted including 105 full term pregnant women scheduled for cesarean delivery...
January 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29330635/hypotension-due-to-spinal-anesthesia-influences-fetal-circulation-in-primary-caesarean-sections
#19
K Lato, I Bekes, Peter Widschwendter, T W P Friedl, W Janni, F Reister, G Froeba, U Friebe-Hoffmann
PURPOSE: Hypotension due to spinal anesthesia is a well-known side effect in pregnant women receiving caesarean section. Little is known about its impact on fetal blood circulation. METHODS: 40 women with uncomplicated singleton term pregnancies prepared for caesarean section were prospectively evaluated by Doppler sonography before and immediately after spinal anesthesia. RESULTS: In 90% of the women, blood pressure significantly decreased after spinal anesthesia and 42...
March 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29325592/magnesium-sulphate-for-fetal-neuroprotection-to-prevent-cerebral-palsy-mag-cp-implementation-of-a-national-guideline-in-canada
#20
Dane A De Silva, Anne R Synnes, Peter von Dadelszen, Tang Lee, Jeffrey N Bone, Laura A Magee
BACKGROUND: Evidence supports magnesium sulphate (MgSO4) for women at risk of imminent birth at < 32-34 weeks to reduce the likelihood of cerebral palsy in the child. MAGnesium sulphate for fetal neuroprotection to prevent Cerebral Palsy (MAG-CP) was a multifaceted knowledge translation (KT) strategy for this practice. METHODS: The KT strategy included national clinical practice guidelines, a national online e-learning module and, at MAG-CP sites, educational rounds, focus group discussions and surveys of barriers and facilitators...
January 11, 2018: Implementation Science: IS
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