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https://www.readbyqxmd.com/read/28425250/retrospective-analysis-of-maternal-fetal-and-neonatal-outcomesof-intrahepatic-cholestasis-of-pregnancy-at-gazi-university
#1
Berrin Günaydin, Merih Bayram, Melis Altuğ, Semra Cevher, Nuray Bozkurt
BACKGROUND/AIM: Maternal, fetal, and neonatal outcomes in parturients with intrahepatic cholestasis of pregnancy (ICP) have been retrospectively documented. We aimed to present pregnancy outcomes of parturients with ICP who underwent delivery. The study was conducted during a 1-year period. MATERIALS AND METHODS: After ethics committee approval, data from 1 January to 31 December 2015 were collected to identify parturients with ICP. RESULTS: Ten out of 37 patients underwent normal spontaneous vaginal delivery (NSVD), and the remaining 27 parturients underwent cesarean section (CS)...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28415680/long-term-neurocognitive-dysfunction-in-offspring-via-ngf-erk-creb-signaling-pathway-caused-by-ketamine-exposure-during-the-second-trimester-of-pregnancy-in-rats
#2
Yanan Li, Xinran Li, Cen Guo, Lina Li, Yuxin Wang, Yiming Zhang, Yu Chen, Wenhan Liu, Li Gao
Early life exposure to ketamine caused neurohistopathologic changes and persistent cognitive dysfunction. For this study, a pregnant rat model was developed to investigate neurocognitive effects in the offspring, following ketamine exposure during the second trimester. Pregnant rats on gestational day 14 (equal to midtrimester pregnancy in humans), intravenously received 200 mg/kg ketamine for 3 h. Their behavior was tested (Morris water maze, odor recognition test, and fear conditioning) at postnatal days (P25-30)...
March 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28413279/comparing-slow-and-rapid-bolus-of-ephedrine-in-pregnant-patients-undergoing-planned-cesarean-section-under-spinal-anesthesia
#3
Prabu Gunasekaran, Lenin Babu Elakkumanan, Hemavathi Balachander, M V S Satyaprakash
BACKGROUND AND AIMS: While ephedrine was the preferred drug for treating spinal-induced hypotension in pregnancy, its use has declined because of resultant fetal acidosis. The objective of this randomized control trial was to compare the effects of a slow and rapid bolus of ephedrine on fetal acidosis, maternal blood pressure, and heart rate (HR) during cesarean section performed under spinal anesthesia. MATERIAL AND METHODS: Eighty full-term parturients scheduled for cesarean section under spinal anesthesia were randomly allocated into two groups...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28413274/evaluation-of-decision-to-delivery-interval-in-emergency-cesarean-section-a-1-year-prospective-audit-in-a-tertiary-care-hospital
#4
Sunanda Gupta, Udita Naithani, C Madhanmohan, Ajay Singh, Pradeep Reddy, Apoorva Gupta
BACKGROUND AND AIMS: The American College of Obstetricians and Gynecologists (ACOG) committee on professional standards and the National Institute of Clinical Excellence (NICE) guidelines suggest that decision-to-delivery interval (DDI) and emergency cesarean section (CS) should not be more than 30 min, and a delay of more than75 min in the presence of maternal or fetal compromise can lead to poor outcome. This prospective 1-year study was conducted on emergency CS in a tertiary care hospital to evaluate the DDI, factors affecting it and to analyze their effects on maternal and neonatal outcome...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28396687/successful-treatment-of-caesarean-scar-pregnancies-by-local-treatment-only
#5
Shinji Tanigaki, Chie Nagata, Kazunori Ueno, Nobuaki Ozawa, Shinichi Nagaoka, Kei Tanaka, Haruhiko Sago, Mitsutoshi Iwashita
Background. Caesarean scar pregnancy (CSP) is a rare ectopic pregnancy associated with life-threatening complications. To date, no therapeutic protocols have been established. Sono-guided local methotrexate (MTX) injection is a relatively easy and low-invasive treatment. Additional systemic MTX is sometimes needed for CSP cases, especially when β-subunit human chorionic gonadotropin (β-hCG) levels are >20,000 mIU/ml at diagnosis. We report on six cases of CSP treated with local MTX injection, five of which received combined local treatment...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28367293/thoracic-interfascial-nerve-block-for-breast-surgery-in-a-pregnant-woman-a-case-report
#6
Boohwi Hong, Seok-Hwa Yoon, Ann Misun Youn, Bum June Kim, Seunghyun Song, Yeomyung Yoon
Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. The Pecs II block is an interfascial block that targets not only the medial and lateral pectoral nerves, but also the lateral cutaneous branch of the intercostal nerve. Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28337942/is-fetal-analgesia-necessary-during-prenatal-surgery
#7
C V Bellieni, S Vannuccini, F Petraglia
Fetal anesthesia is still matter of debate: some authors hypothesize that several intrauterine endogenous neuroinhibitors (ENIn) anesthetize the fetus, keeping it in a constant state of sleep, and making pharmacological fetal anaesthesia useless for fetal surgery. AIM: To retrieve evidences about fetal pain, fetal arousability and about the level of sedation induced by the ENIn, in order to assess the necessity of direct fetal anesthesia during prenatal fetal surgery. METHODS: We performed a careful literature review (1990-2016) on fetal arousability, and on the possibility that ENIn at the average fetal blood levels induce actual anesthesia...
March 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28333816/committee-opinion-no-696-nonobstetric-surgery-during-pregnancy
#8
(no author information available yet)
The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice acknowledges that the issue of nonobstetric surgery during pregnancy is an important concern for physicians who care for women. It is important for a physician to obtain an obstetric consultation before performing nonobstetric surgery and some invasive procedures (eg, cardiac catheterization or colonoscopy) because obstetricians are uniquely qualified to discuss aspects of maternal physiology and anatomy that may affect intraoperative maternal-fetal well-being...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28320344/risk-factors-associated-with-adverse-perinatal-outcome-in-planned-vaginal-breech-labors-at-term-a-retrospective-population-based-case-control-study
#9
Georg Macharey, Mika Gissler, Veli-Matti Ulander, Leena Rahkonen, Mervi Väisänen-Tommiska, Mika Nuutila, Seppo Heinonen
BACKGROUND: Vaginal breech delivery is associated with adverse perinatal outcome. The aim of this study was to identify factors associated with adverse perinatal outcome in term breech pregnancies, and to provide clinicians an aid in selecting women for a trial of vaginal labor with the fetus in breech position. METHODS: We conducted a retrospective, nationwide, Finnish population-based case-control study. All planned singleton vaginal deliveries at term with the fetus in breech position between the years 2005 and 2014 were analyzed...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28301889/geburtshilfe-an%C3%A3-sthesie-bei-exit-prozedur
#10
Alexander Torossian
The ex utero intrapartum treatment (EXIT) procedure is performed as a part of an extended caesarean section for example to treat fetal airway disorders. For treatment, optimal uterine relaxation is necessary, however utero-placental supply of the fetus has to be guaranteed as well. "Balanced" anesthesia, tocolysis and tight maternal arterial blood pressure control are recommended. Standard fetal monitoring comprises pulse oxymetry and echocardiography. The article describes the physiology and anesthestic goals of the EXIT procedure, discusses alternative anesthesia techniques and gives an outlook on emerging progress...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28279665/multiple-sevoflurane-anesthesia-in-pregnant-mice-inhibits-neurogenesis-of-fetal-hippocampus-via-repressing-transcription-factor-pax6
#11
Fang Fang, Ruixue Song, Xiaomin Ling, Mengyuan Peng, Zhanggang Xue, Jing Cang
Sevoflurane is widely used in non-obstetric surgeries of pregnant women, but its influences on fetal brain are still not fully known. We set out to assess the effects of multiple maternal sevoflurane exposure on neurogenesis and cognitive dysfunction in fetus and offspring. Pregnant mice (gestational day 15.5) and cultured mouse neural stem cells (NSCs) received daily sevoflurane exposure (2.5%×2h and 4.1%×2h respectively) for three consecutive days. Cognitive function of the offspring was determined with the Morris water maze...
April 15, 2017: Life Sciences
https://www.readbyqxmd.com/read/28275857/influence-of-maternal-remifentanil-concentration-on-fetal-to-maternal-ratio-in-pregnant-ewes
#12
Masaki Sato, Kenichi Masui, Borjigin Sarentonglaga, Mio Yamaguchi, Rika Fukumori, Yoshikazu Nagao, Haruhiko Sago, Hiroyuki Sumikura
PURPOSE: Maternal remifentanil infusion is used for minimally invasive fetal surgery or ex-utero intrapartum treatment. The fetal-to-maternal (F/M) ratio of remifentanil concentration at various dosing regimens is useful to manage remifentanil effects. The aim of this study was to investigate the F/M ratio of remifentanil at various concentrations. METHODS: Five pregnant ewes received continuous remifentanil infusion under propofol anesthesia. The remifentanil infusion rate was increased by 0...
March 8, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28268059/ethical-issues-in-fetal-therapy
#13
REVIEW
Amirhossein Moaddab, Ahmed A Nassr, Michael A Belfort, Alireza A Shamshirsaz
The introduction of routine fetal ultrasound and the technical improvements in ultrasound equipment have greatly increased our ability to diagnose fetal anomalies. As a consequence, congenital anomalies are diagnosed today earlier and in a greater number of patients than ever before. The development of fetal intervention and fetal surgery techniques, improved anesthesia methodology, and sophisticated perinatal care at the limits of viability, have now made prenatal management of some birth defects or fetal malformations a reality...
February 12, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#14
Julio A Jiménez, Elisenda Eixarch, Philip DeKoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia defect allows viscera to herniate into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. Antenatal measurement of lung size and liver herniation can predict survival after birth. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion under local anesthesia...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28256306/clinical-follow-up-of-pregnancy-in-myasthenia-gravis-patients
#15
Renata D Ducci, Paulo J Lorenzoni, Claudia S K Kay, Lineu C Werneck, Rosana H Scola
This study aimed to analyze the outcome and impact of pregnancy in women with myasthenia gravis (MG). Obstetric and clinical data were retrospectively analyzed before, during and after pregnancy. Predictors of outcome were studied. We included 35 pregnancies from 21 MG patients. In the course of MG symptoms in 30 pregnancies with live births, 50% deteriorated (mainly during the second trimester, p = 0.028), 30% improved, and 20% remained unchanged. The deterioration group had more frequent abnormal repetitive nerve stimulation (RNS) (p = 0...
February 1, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28244950/anesthetic-management-for-percutaneous-minimally-invasive-fetoscopic-surgery-of-spina-bifida-aperta-a-retrospective-descriptive-report-of-clinical-experience
#16
Christoph Arens, Christian Koch, Mirko Veit, Robert Steven Greenberg, Christoph Lichtenstern, Markus Alexander Weigand, Anastasiia Khaleeva, Rainer Schuerg, Thomas Kohl
Minimally invasive fetoscopic surgery for spina bifida aperta is a new therapeutic approach to preserve neurologic function by protecting exposed neural tissue. The anesthetic management is of paramount importance for the success of the procedure. Therefore, our protocol was developed with particular attention to safe and adequate maternal and fetal anesthesia, sufficient uterine relaxation as well as prevention of pulmonary edema, placental abruption, and spontaneous labor. As illustrated by this retrospective analysis of 61 cases, these goals can be reliably achieved...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28238025/anesthetic-management-of-abdominal-radical-trachelectomy-for-uterine-cervical-cancer-during-pregnancy
#17
Jun Terukina, Misako Takamatsu, Takayuki Enomoto, Hiroshi Baba
Abdominal radical trachelectomy has been identified as a surgical option for fertility preservation in cervical cancer patients, particularly in pregnant women who strongly desire to continue their pregnancy. Since this procedure requires operating in the uterus, the hardness of the uterus can affect the ease of surgery. Generally, sevoflurane is used for anesthesia in non-obstetric surgery for pregnant women because uterine relaxation is advantageous for uterine blood flow maintenance. However, the use of sevoflurane during radical trachelectomy has not been thoroughly evaluated...
February 25, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28235526/cardiac-output-changes-with-phenylephrine-and-ephedrine-infusions-during-spinal-anesthesia-for-cesarean-section-a-randomized-double-blind-trial
#18
W Mon, A Stewart, R Fernando, K Ashpole, N El-Wahab, S MacDonald, P Tamilselvan, M Columb, Y M Liu
Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 μg/min or ephedrine 5 mg/min infusions...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28213879/arthrogryposis-multiplex-congenita-classification-diagnosis-perioperative-care-and-anesthesia
#19
REVIEW
Lulu Ma, Xuerong Yu
Arthrogryposis multiplex congenita (AMC) is a rare disorder characterized by non-progressive, multiple contractures. In addition to affected extremities, patients may also present microstomia, decreased temporomandibular joint mobility. Although the etiology of AMC is unclear, any factor that decreases fetal movement is responsible for AMC. Thus, accurate diagnosis and classification are crucial to the appropriate treatment of AMC. The development of ultrasound technology has enabled prenatal diagnosis. Very early treatment is favorable, and multidisciplinary treatment is necessary to improve the function of AMC patients...
March 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28211140/anesthesia-for-fetal-surgery
#20
REVIEW
Monica A Hoagland, Debnath Chatterjee
Fetal therapy is an exciting and growing field of medicine. Advances in prenatal imaging and continued innovations in surgical and anesthetic techniques have resulted in a wide range of fetal interventions including minimally invasive, open mid-gestation, and ex-utero intrapartum treatment procedures. The potential for maternal morbidity is significant and must be carefully weighed against claimed benefits to the fetus. Appropriate patient selection is critical, and a multidisciplinary team-based approach is strongly recommended...
April 2017: Paediatric Anaesthesia
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