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hypotension maternal

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https://www.readbyqxmd.com/read/27898546/lateral-position-for-cesarean-delivery-because-of-severe-aortocaval-compression-in-a-patient-with-marfan-syndrome-a-case-report
#1
John C Coffman, Russell L Legg, Catherine F Coffman, Kenneth R Moran
Prompt recognition and management of hypotension resulting from aortocaval compression syndrome are essential to optimize the maternal and fetal outcomes. Management involves increasing leftward uterine displacement and sometimes full lateral positioning, although lateral position during cesarean delivery is typically considered to be impractical. We report an obstetric patient case of severe aortocaval compression syndrome resulting in hypotension and loss of consciousness that ultimately underwent cesarean delivery under general anesthesia in the lateral position...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27891272/spontaneous-rupture-of-uterine-artery-in-a-14-week-pregnant-woman
#2
João Paulo Mancusi de Carvalho, Luciano Augusto de Carvalho Severo, Maria Helena Mancusi de Carvalho, Marina de Paula Andres, Mariano Tamura Vieira Gomes, Sergio Podgaec
We report a case of uterine artery rupture in a woman at 14 weeks' gestation who presented with abdominal pain, tachycardia, and hypotension and underwent a diagnostic laparoscopy. During this procedure, a spontaneous rupture of the left uterine artery was diagnosed and the surgery was converted into a laparotomy. The artery was bound to its origin and to its distal uterine portion. The patient exhibited excellent postoperative recovery and was discharged two days after the surgery. The pregnancy continued without other maternal or fetal complications, and the patient delivered a healthy newborn via cesarean section at 39 weeks of gestation...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27789074/prediction-of-hypotension-during-spinal-anesthesia-for-elective-cesarean-section-by-altered-heart-rate-variability-induced-by-postural-change
#3
K Sakata, N Yoshimura, K Tanabe, K Kito, K Nagase, H Iida
BACKGROUND: Maternal hypotension is a common complication during cesarean section performed under spinal anesthesia. Changes in maternal heart rate with postural changes or values of heart rate variability have been reported to predict hypotension. Therefore, we hypothesized that changes in heart rate variability due to postural changes can predict hypotension. METHODS: A total of 45 women scheduled to undergo cesarean section under spinal anesthesia were enrolled...
September 22, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27755062/amniotic-fluid-embolism
#4
Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly in effort to treat potential complications...
October 13, 2016: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/27746565/evaluation-of-antihypotensive-techniques-for-cesarean-section-under-spinal-anesthesia-rapid-crystalloid-hydration-versus-intravenous-ephedrine
#5
Kalpana Rajendra Kulkarni, Amruta Girish Naik, Sunetra Girish Deshpande
BACKGROUND: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. AIMS: We aimed to evaluate the efficacy of 15 mL.kg- 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27720613/an-open-label-randomized-controlled-clinical-trial-for-comparison-of-continuous-phenylephrine-versus-norepinephrine-infusion-in-prevention-of-spinal-hypotension-during-cesarean-delivery
#6
M C Vallejo, A F Attaallah, O M Elzamzamy, D T Cifarelli, A L Phelps, G R Hobbs, R E Shapiro, P Ranganathan
BACKGROUND: During spinal anesthesia for cesarean delivery phenylephrine is the vasopressor of choice but can cause bradycardia. Norepinephrine has both β- and α-adrenergic activity suitable for maintaining blood pressure with less bradycardia. We hypothesized that norepinephrine would be superior to phenylephrine, requiring fewer rescue bolus interventions to maintain blood pressure. METHODS: Eighty-five parturients having spinal anesthesia for elective cesarean delivery were randomized to Group P (phenylephrine 0...
August 28, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27687377/a-randomized-trial-comparing-prophylactic-phenylephrine-and-ephedrine-infusion-during-spinal-anesthesia-for-emergency-cesarean-delivery-in-cases-of-acute-fetal-compromise
#7
Kajal Jain, Jeetinder Kaur Makkar, Siva Subramani Vp, Shalini Gander, Praveen Kumar
BACKGROUND: Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. METHODS: Ninety parturients showing acute fetal compromise during intrapartum period and taken up for CD (category II) under spinal anesthesia were randomized to receive prophylactic infusion of ephedrine 2...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27631446/-the-new-german-guideline-on-postpartum-haemorrhage-pph-essential-aspects-for-coagulation-and-circulatory-therapy
#8
Heiko Lier, Dietmar Schlembach, Wolfgang Korte, Christian von Heymann, Susanne Steppat, Maritta Kühnert, Holger Maul, Wolfgang Henrich, Werner Rath, Jürgen Wacker, Franz Kainer, Daniel Surbek, Hanns Helmer
Worldwide, post-partum haemorrhage (PHH) remains one of the leading causes for maternal mortality. The German Society of Gynaecology and Obstetrics, the German Midwifes' Society, the German Society of Thrombosis and Haemostasis and the German Society of Anaesthesiology and Intensive Care updated the former guideline. The resulting recommendations are the results of a structured literature search and a formal consensus process and contain all aspects of PPH including diagnosis, causes, risk factors and therapy...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27607862/maternal-death-due-to-clostridium-novyi-in-an-injection-drug-user
#9
Christina Herrera, Ryan Meehan, Varsha Podduturi, Alexander L Eastman, David B Nelson
BACKGROUND: Soft-tissue infections in women with subcutaneous injection drug use are often polymicrobial. CASE: A 21-year-old nulliparous woman presented at 14-15 weeks of gestation with several gluteal abscesses related to subcutaneous injection of heroin. She was well appearing, afebrile, and without findings of systemic illness. After empiric broad-spectrum intravenous antibiotics, same-day incision and drainage was performed. Immediately after the procedure, she developed refractory hypotension, severe tachycardia, pulmonary edema, and leukemoid reaction (white blood cell count 80×10/L)...
October 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27607089/amniotic-fluid-embolism-after-intrauterine-fetal-demise
#10
Karl Kristensen, Fali Langdana, Howard Clentworth, Chu Hansby, Paul Dalley
We present a case of the successful treatment of severe amniotic fluid embolism in a 41-year-old woman undergoing emergency caesarean section at 36 weeks of gestation for placental abruption and intrauterine fetal demise. The treatment included prolonged cardiopulmonary resuscitation, emergency hysterectomy, re-operation with intra-abdominal packing and intra-aortic balloon pump insertion. The patient made a remarkable recovery and to date has minimal residual morbidity. Amniotic fluid embolism syndrome (AFES) is a rare and often fatal obstetric condition that remains one of the main causes of maternal mortality in developed countries...
2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27605955/a-randomised-controlled-trial-comparing-weight-adjusted-dose-versus-fixed-dose-prophylactic-phenylephrine-infusion-on-maintaining-systolic-blood-pressure-during-caesarean-section-under-spinal-anaesthesia
#11
Lucy Mwaura, Vitalis Mung'ayi, Jimmie Kabugi, Samina Mir
BACKGROUND: Spinal anaesthesia is the standard of care for elective caesarean delivery. It has advantages over general anaesthesia. However the sympathetic blockade induced by spinal anaesthesia results in an 80 percent incidence of hypotension without prophylactic management. Current evidence supports co-loading with intravenous fluids in conjunction with the use of vasopressors as the most effective way to prevent and treat the hypotension. Phenylephrine is the accepted vasopressor of choice in the parturient...
June 2016: African Health Sciences
https://www.readbyqxmd.com/read/27555198/randomized-study-of-postcesarean-analgesia-with-intrathecal-morphine-alone-or-combined-with-clonidine
#12
Francisco A E Carvalho, Sérgio B Tenório, Fabiano T Shiohara, Luiz R Maia, Angela Mota
STUDY OBJECTIVE: To investigate the efficacy of the combination of intrathecal morphine with clonidine in comparison with 2 doses of intrathecal morphine alone for postcesarean analgesia. DESIGN: Prospective, double-blinded, randomized clinical trial. SETTING: Maternity ward of Hospital Santa Cruz, Curitiba, Paraná, Brazil (operating room and ward). PATIENTS: The study included 195 American Society of Anesthesiologist I to III singleton parturients undergoing elective cesarean section...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27537759/the-effects-of-vasopressin-and-oxytocin-on-the-fetoplacental-distal-stem-arteriolar-vascular-resistance-of-the-dual-perfused-single-isolated-human-placental-cotyledon
#13
John W Downing, Curtis L Baysinger, Raymond F Johnson, Ray L Paschall, Matthew S Shotwell
BACKGROUND: Vasoactive agents administered to counter maternal hypotension at cesarean delivery may theoretically intensify the hypoxemic fetoplacental vasoconstrictor response and, hence, negatively impact transplacental oxygen delivery to the fetus. Yet, this aspect of their pharmacodynamic profiles is seldom mentioned, let alone investigated. We hypothesized that vasopressin, a potent systemic vasoconstrictor, and oxytocin, a uterotonic agent administered routinely at cesarean delivery, which, in contrast to vasopressin, possesses significant systemic vasodilator properties, would not influence distal stem villous arteriolar resistance...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27509653/-head-injury-during-pregnancy
#14
REVIEW
I Vulkov, Pl Bozhinov
No matter how severe is head injury during pregnancy, it can threaten both- the maternal and (or) the fetal life. The risk derives from systemic and cerebral consequences of high intracranial pressure, hypotension, anemia or expanding mass lessions in the cranial cavity. The specific hormonal background of the mother may contribute the better outcome after traumatic brain injury (TBI). Pregnancy and trauma push the doctors to create different and specific management than the usual case. Investigating literature data we figure out the initial assessment, management priorities for resuscitation of the head injured pregnant patient, concidering the specific anatomic and physiologic changes during pregnancy...
2016: Akusherstvo i Ginekologii︠a︡
https://www.readbyqxmd.com/read/27501618/anesthetic-techniques-and-incidence-of-complications-in-fetoscopic-surgery
#15
Patchareya Nivatpumin, Pawinee Pangthipampai, Tachawan Jirativanont, Sukanya Dej-Arkom, Namtip Triyasunant, Thongchai Tempeetikul
BACKGROUND: Nowadays, fetoscopic surgery has been accepted to be a procedure to correct numerous congenital anomalies. This operation can be successfully done under general, regional or local anesthesia with sedation. Incidence of complications from anesthesia in fetoscopic surgery has not been reported in Thailand. OBJECTIVE: To describe anesthetic techniques and incidence of complications in fetoscopic surgery. MATERIAL AND METHOD: Data of 152 pregnant women undergoing fetoscopic surgery in a single university hospital was retrospectively chart reviewed from June 2005 to November 2015...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27405251/effect-of-dialysis-on-fetal-heart-rate-is-inpatient-admission-for-fetal-monitoring-necessary
#16
Matthew H Loichinger, Autumn J Broady, Kelly Yamasato, Emily Mills, P Gordon McLemore, Dena Towner
OBJECTIVE: Pregnant patients receiving hemodialysis (HD) have long hospital stays for the purpose of electronic fetal monitoring (EFM) during HD, which allows for monitoring of fetal well-being. However, more frequent dialysis allows for smaller fluid shifts, preventing maternal hypotension. Our aim was to determine differences in rates of EFM abnormalities during HD versus non-stress testing (NST) off dialysis for gravid women with renal failure. METHODS: Retrospective cohort study over a 13-year period (2000-2013) identified five patients with renal failure in pregnancy...
July 12, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27382807/continuous-non-invasive-arterial-pressure-device-as-an-adjunct-to-recognize-fluctuating-blood-pressures-during-elective-cesarean-section-under-subarachnoid-blockade-sab
#17
Deepak Gupta, Vitaly Soskin, Milos Marjanovic, Hassan Amhaz, Ashish Mazumdar
BACKGROUND: Measuring non-invasive blood pressure (NIBP) in less than one minute intervals (STAT NIBP measurements) is not always feasible. Therefore, large number of undetectable hypotension episodes can only be recognized with continuous beat to beat monitoring of blood pressure, for example, by continuous non-invasive arterial pressure monitor (CNAP). OBJECTIVE: The purpose of the current study was to investigate whether CNAP correlates well with conventional intermittent oscillometric NIBP during elective cesarean sections under subarachnoid blockade (SAB) and whether CNAP based patient management results in improved immediate maternal vasopressor requirements and improved immediate fetal/neonatal outcomes compared with NIBP based patient management...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27275330/maternal-and-neonatal-effects-of-vasopressors-used-for-treating-hypotension-after-spinal-anesthesia-for-caesarean-section-a-randomized-controlled-study
#18
Alma Soxhuku-Isufi, Vjollca Shpata, Hektor Sula
AIM: The aim of the study was to examine whether ephedrine and phenylephrine were different in their efficacy for managing maternal hypotension and their effect of adverse maternal and neonatal outcome. METHODS: A double-blind randomized controlled study in healthy pregnant women ASA physical status 2, which underwent elective caesarian delivery under spinal anesthesia. Patients were randomized to receive an intravenous bolus of either phenylephrine (Ph group) or ephedrine (E group) immediately after the episode of hypotension after spinal anesthesia...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27275041/amniotic-fluid-embolism
#19
REVIEW
Kiranpreet Kaur, Mamta Bhardwaj, Prashant Kumar, Suresh Singhal, Tarandeep Singh, Sarla Hooda
Amniotic fluid embolism (AFE) is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the maternal pulmonary circulation, causing cardiovascular collapse. Etiology largely remains unknown, but may occur in healthy women during labour, during cesarean section, after abnormal vaginal delivery, or during the second trimester of pregnancy. It may also occur up to 48 hours post-delivery. It can also occur during abortion, after abdominal trauma, and during amnio-infusion...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27268024/do-low-risk-nulliparous-women-with-abnormal-uterine-artery-doppler-in-the-third-trimester-have-poorer-perinatal-outcomes-a-longitudinal-prospective-study-on-uterine-artery-doppler-in-low-risk-nulliparous-women-and-correlation-with-pregnancy-outcomes
#20
M Arrue, M García, M T Rodriguez-Bengoa, J M Landa, L Urbieta, M Maiztegui, L Salgueiro, M Belar, J C Trecet, A Lekuona
OBJECTIVE: To evaluate uterine artery (UtA) Doppler over the course of pregnancy in low-risk nulliparous women and to analyze whether an abnormal uterine artery pulsatility index (UtA-PI) at a 32-34 week' scan implies poorer perinatal outcomes. METHODS: An observational prospective study was carried out including 616 low-risk nulliparous women. Women with any of the following were excluded: fetal abnormalities, multiple pregnancy, and heparin, metformin or hypotensive treatment...
June 8, 2016: Journal of Maternal-fetal & Neonatal Medicine
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