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https://www.readbyqxmd.com/read/29243058/does-prophylactic-ondansetron-reduce-norepinephrine-consumption-in-patients-undergoing-cesarean-section-with-spinal-anesthesia
#1
Feride Karacaer, Ebru Biricik, İlker Ünal, Selim Büyükkurt, Hakkı Ünlügenç
PURPOSE: Spinal anesthesia-induced hypotension (SAIH) during cesarean delivery is not rare and frequently leads to materno-fetal discrepancy and collapse. More recently, norepinephrine has been proposed for the prevention and treatment of SAIH with fewer tendencies to decrease heart rate and cardiac output. Ondansetron has been reported to reduce the incidence of SAIH in patients undergoing cesarean section. The aim of the present study was to assess the effect of prophylactic ondansetron on the incidence of SAIH, norepinephrine consumption, and adverse effects...
December 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29228401/middle-cerebral-artery-doppler-changes-following-fetal-transfusion-performed-with-and-without-fetal-anesthesia
#2
Kristen R Uquillas, Myrna S Aboudiab, Lisa M Korst, Arlyn Llanes, Brendan H Grubbs, Ramen H Chmait
No abstract text is available yet for this article.
December 11, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29225748/multiple-exposures-of-sevoflurane-during-pregnancy-induces-memory-impairment-in-young-female-offspring-mice
#3
Woosuk Chung, Seunghwan Yoon, Yong Sup Shin
Background: Earlier studies have reported conflicting results regarding long-term behavioral consequences after anesthesia during the fetal period. Previous studies also suggest several factors that may explain such conflicting data. Thus, we examined the influence of age and sex on long-term behavioral consequences after multiple sevoflurane exposures during the fetal period. Methods: C57BL/6J pregnant mice received oxygen with or without sevoflurane for 2 hours at gestational day (GD) 14-16...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29209926/a-randomized-trial-of-phenylephrine-infusion-versus-bolus-dosing-for-nausea-and-vomiting-during-cesarean-delivery-in-obese-women
#4
Ronald B George, Dolores M McKeen, Jennifer E Dominguez, Terrence K Allen, Patricia A Doyle, Ashraf S Habib
PURPOSE: Hypotension is common after spinal anesthesia for Cesarean delivery. It is associated with nausea, vomiting, and fetal acidosis. Previous research on phenylephrine excluded obese subjects. We compared the incidence of intraoperative nausea and vomiting (IONV) in obese patients who received a prophylactic phenylephrine infusion vs those who received bolus dosing for the treatment of spinal-induced hypotension. METHODS: In this multicentre, double-blinded randomized controlled trial, 160 obese women undergoing elective Cesarean delivery under spinal anesthesia were randomized to receive a prophylactic phenylephrine infusion initiated at 50 μg·min-1 (and titrated according to a predefined algorithm) or 100 μg phenylephrine boluses to treat hypotension...
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29166810/anesthetic-management-of-amniotic-fluid-embolism-a-multi-center-prospective-cohort-study
#5
Shiri Skolnik, Alexander Ioscovich, Leonid A Eidelman, Atara Davis, Anat Shmueli, Amir Aviram, Sharon Orbach-Zinger
INTRODUCTION: Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management. Our primary objective in this study was to evaluate clinical presentation of AFE and delineate anesthesia management of these cases. METHODS: This 10 years retrospective multi-center cohort study was performed in five tertiary university-affiliated medical centers, between the years 2005 and 2015...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#6
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29099429/the-society-for-obstetric-anesthesia-and-perinatology-consensus-statement-on-the-anesthetic-management-of-pregnant-and-postpartum-women-receiving-thromboprophylaxis-or-higher-dose-anticoagulants
#7
Lisa Leffert, Alexander Butwick, Brendan Carvalho, Katherine Arendt, Shannon M Bates, Alex Friedman, Terese Horlocker, Timothy Houle, Ruth Landau, Heloise Dubois, Roshan Fernando, Tim Houle, Sandra Kopp, Douglas Montgomery, Joseph Pellegrini, Richard Smiley, Paloma Toledo
Venous thromboembolism is recognized as a leading cause of maternal death in the United States. Thromboprophylaxis has been highlighted as a key preventive measure to reduce venous thromboembolism-related maternal deaths. However, the expanded use of thromboprophylaxis in obstetrics will have a major impact on the use and timing of neuraxial analgesia and anesthesia for women undergoing vaginal or cesarean delivery and other obstetric surgeries. Experts from the Society of Obstetric Anesthesia and Perinatology, the American Society of Regional Anesthesia, and hematology have collaborated to develop this comprehensive, pregnancy-specific consensus statement on neuraxial procedures in obstetric patients receiving thromboprophylaxis or higher dose anticoagulants...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29098009/maternal-sevoflurane-exposure-causes-abnormal-development-of-fetal-prefrontal-cortex-and-induces-cognitive-dysfunction-in-offspring
#8
Ruixue Song, Xiaomin Ling, Mengyuan Peng, Zhanggang Xue, Jing Cang, Fang Fang
Maternal sevoflurane exposure during pregnancy is associated with increased risk for behavioral deficits in offspring. Several studies indicated that neurogenesis abnormality may be responsible for the sevoflurane-induced neurotoxicity, but the concrete impact of sevoflurane on fetal brain development remains poorly understood. We aimed to investigate whether maternal sevoflurane exposure caused learning and memory impairment in offspring through inducing abnormal development of the fetal prefrontal cortex (PFC)...
2017: Stem Cells International
https://www.readbyqxmd.com/read/29076367/maternal-and-fetal-effects-of-dexmedetomidine-infusion-in-pregnant-ewes-anesthetized-with-sevoflurane
#9
Mauricio Loría Lépiz, Rebecca Sayre, Onkar Sawant, James Barr, Medora Pashmakova, Kevin Washburn, Shannon Washburn
OBJECTIVE To characterize the maternal and fetal cardiopulmonary effects of a low-dose infusion of dexmedetomidine without a loading dose in pregnant ewes anesthetized with sevoflurane. ANIMALS 11 pregnant ewes. PROCEDURES Anesthesia was induced with propofol and maintained with sevoflurane. Ewes and fetuses were instrumented with arterial and venous catheters, and thermodilution-pulmonary arterial catheters were placed in the ewes. Baseline measurements were obtained at an end-tidal sevoflurane concentration of 3...
November 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29073508/lower-limbs-venous-compression-reduces-the-incidence-of-maternal-hypotension-following-epidural-analgesia-during-term-labor
#10
Violaine Peyronnet, Arnaud Roses, Aude Girault, Marie Pierre Bonnet, Francois Goffinet, Vassilis Tsatsaris, Edouard Lecarpentier
OBJECTIVE(S): Every year in France, 10% to 20% of the 600 000 women given epidural analgesia during labor experience hypotension, which in 15% of cases is associated with fetal heart rate abnormalities. The efficiency of lower limbs venous compression in preventing the occurrence of maternal hypotension after neuraxial anesthesia has already been demonstrated, but only in the context of scheduled cesarean section. We assessed the preventive effect of medical lower limbs venous compression on the incidence of maternal hypotension after epidural analgesia during spontaneous term labor...
October 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29049219/risk-assessment-of-morbidly-obese-parturient-in-cesarean-section-delivery-a-prospective-cohort-single-center-study
#11
Xiaohu An, Yanhong Zhao, Ying Zhang, Qiling Yang, Yilong Wang, Weiwei Cheng, Zeyong Yang
BACKGROUND: Up to 40% of women gain excessive weight during pregnancy. Obesity complications and risks in parturient women undergoing cesarean section (CS) with different anesthetic methods remain unknown. This study aimed to assess the safety and risk of obese women undergoing CS delivery with various perioperative anesthetic methods. METHODS: Seven hundred ninety parturient women underwent CS under general anesthesia (GA), intraspinal anesthesia including epidural anesthesia (EA) and combined spinal-epidural anesthesia (CSEA)...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29026065/urethral-diverticulum-presenting-as-a-large-vaginal-mass-complicating-pregnancy-and-delivery
#12
Everett F Magann, Lisa S Newton, Susan A Barr
BACKGROUND A case report of urethral diverticulum complicating pregnancy is presented. The diagnosis and management are challenging because of the rare nature of this condition, the varied presentations and differential diagnoses, and the possibility of misdiagnosis. CASE REPORT A 25-year-old primigravida with scheduled induction of labor at 39 weeks gestation due to gestational diabetes mellitus presented for a routine antenatal appointment at 38 weeks and four days. On digital cervical examination, she was found to have a large semi-solid anterior vaginal mass, shown by trans-vaginal ultrasound to have a nearly solid appearance of a 5×7 cm mass with septation...
October 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29020780/-selective-feticide-in-monochorionic-twin-pregnancies-with%C3%A2-discordant-fetal-anomalies-management-and-outcome
#13
J Vojtěch, L Hašlík, R Pock, K Běhávková, K Macková, P Hanulíková, H Heřman, L Krofta
OBJECTIVE: To analyze results and outcome after selective feticide for discordant anomalies in monochorionic twins. DESIGN: Prospective cohort study. SETTING: Fetal medicine center, Institute for the Care of Mother and Child, Praha. METHODS: Analysis of outcome of monochorionic pregnancies after intrauterine surgery for structural abnormalities between January 2013 and June 2016. RESULTS: We performed 13 intrauterine operations in monochorionic twins with structural anomalies during the period...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28967071/outcomes-of-cataract-surgery-in-children-with-persistent-hyperplastic-primary-vitreous
#14
Jitender Jinagal, Parul C Gupta, Jagat Ram, Manu Sharma, Simar R Singh, Sonam Yangzes, Jaspreet Sukhija, Ramandeep Singh
PURPOSE: To evaluate postoperative outcomes of cataract surgery in children with persistent hyperplastic primary vitreous (PHPV) and factors affecting outcomes. METHODS: We analyzed 29 eyes of 28 children with PHPV presenting at a tertiary care center in northern India. All eyes underwent phacoaspiration followed by primary posterior capsulotomy with or without cauterization of persistent fetal vasculature under general anesthesia. Hydrophobic intraocular lens was implanted in selective cases...
September 14, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28928588/patient-with-persistent-low-oxygen-saturation-for-emergency-cesarean-section
#15
Shivali Panwar, Kirti Nath Saxena, Prachi Gaba
A 24-year-old woman with previous undiagnosed congenital methemoglobinemia presented for the emergency cesarean section in view of fetal distress. The patient had a persistent low oxygen saturation on pulse oximetry with normal heart rate and blood pressure. Arterial blood gas values were normal. The patient was asymptomatic and respiratory and cardiovascular system examination was normal. The patient underwent cesarean section under general anesthesia and was shifted to the Intensive Care Unit postoperatively...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#16
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28904676/-gestational-diabetes-revealed-by-inaugural-diabetic-ketoacidosis-about-a-case
#17
Serge Irie Bi Gohi, Pete Yaich, Koffi N'guessan, Bernard Ogondon, Yapo Brouh
Ketoacidosis complicating gestational diabetes is rare and responsible for severe maternal-fetal mortality. It is an acute metabolic emergency whose management is multidisciplinary. Early diagnosis and treatment affect the vital prognosis of both the mother and the fetus. We report the case of a 27-year old pregnant woman at term, with a family history of diabetes, admitted to the emergency obstetric care with alertness problems associated with dyspnoea. The diagnosis of inaugural ketoacidosis decompensated due to severe malaria associated with gestational diabetes was retained on the basis of patient's medical history, of clinical examination and paraclinical assessment...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28891072/stable-control-of-physiological-parameters-but-not-infection-in-preterm-lambs-maintained-on-ex-vivo-uterine-environment-therapy
#18
Yuichiro Miura, Haruo Usuda, Shimpei Watanabe, Eleanor Woodward, Masatoshi Saito, Gabrielle C Musk, Suhas G Kallapur, Shinichi Sato, Ryuta Kitanishi, Tadashi Matsuda, John P Newnham, Sarah J Stock, Matthew W Kemp
Ex vivo uterine environment (EVE) therapy is an experimental neonatal intensive care strategy wherein gas exchange is performed by membranous oxygenators attached to the umbilical vessels. Our aim was to assess the ability of a newly refined EVE system to maintain key physiological parameters in preterm lambs within optimal ranges for 48 h. EVE group; n = 6: Preterm lambs were delivered under general anesthesia at 115 ± 2 days of gestational age. Animals were submerged in a bath of artificial amniotic fluid on EVE therapy for 48 h...
September 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28888583/food-and-drug-administration-warning-on-anesthesia-and-brain-development-implications-for-obstetric-and-fetal-surgery
#19
Olutoyin A Olutoye, Byron Wycke Baker, Michael A Belfort, Oluyinka O Olutoye
There has been growing concern about the detrimental effects of certain anesthetic agents on the developing brain. Preclinical studies in small animal models as well as nonhuman primates suggested loss or death of brain cells and consequent impaired neurocognitive function following anesthetic exposure in neonates and late gestation fetuses. Human studies in this area are limited and currently inconclusive. On Dec. 14, 2016, the US Food and Drug Administration issued a warning regarding impaired brain development in children following exposure to certain anesthetic agents used for general anesthesia, namely the inhalational anesthetics isoflurane, sevoflurane, and desflurane, and the intravenous agents propofol and midazolam, in the third trimester of pregnancy...
September 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28868940/vigilance-on-use-of-drugs-herbal-products-and-food-supplements-during-pregnancy-focus-on-fosfomycin
#20
C Mannucci, G Dante, M Miroddi, F Facchinetti, R D'Anna, A Santamaria, M C Lenti, A Vannacci, F Calapai, M Perone, G Migliardi, A Alibrandi, M Navarra, G Calapai
PURPOSE: Urinary tract infection (UTI) is defined as a common bacterial infection that can lead to significant morbidity such as stricture, fistula, abscess formation, bacteremia, sepsis, pyelonephritis, and kidney dysfunction with a mortality rates reported of 1% in men and 3% in women because of development of pyelonephritis. UTIs are more common in women and the 33% of them require antimicrobials treatment for at least one episode by the age of 24 years. UTIs are the most common infections observed during pregnancy and up to 30% of mothers with not treated asymptomatic bacteriuria may develop acute pyelonephritis which consequently can be associated to adverse maternal and fetal outcomes...
September 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
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