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Emergency in obstetric anaesthesia

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https://www.readbyqxmd.com/read/30290812/health-and-sustainable-development-strengthening-peri-operative-care-in-low-income-countries-to-improve-maternal-and-neonatal-outcomes
#1
Isabella Epiu, Josaphat Byamugisha, Andrew Kwikiriza, Meg Amy Autry
BACKGROUND: Uganda is far from meeting the sustainable development goals on maternal and neonatal mortality with a maternal mortality ratio of 383/100,000 live births, and 33% of the women gave birth by 18 years. The neonatal mortality ratio was 29/1000 live births and 96 stillbirths occur every day due to placental abruption, and/or eclampsia - preeclampsia and other unkown causes. These deaths could be reduced with access to timely safe surgery and safe anaesthesia if the Comprehensive Emergency Obstetric and Newborn Care services (CEmONC), and appropriate intensive care post operatively were implemented...
October 5, 2018: Reproductive Health
https://www.readbyqxmd.com/read/30237597/anaesthesia-for-non-obstetric-surgery-in-obstetric-patients
#2
REVIEW
G L Ravindra, Abhinava S Madamangalam, Shwetha Seetharamaiah
Anaesthesia for pregnant patients presenting for non-obstetric surgery needs a thorough understanding of the physiological changes and altered pharmacokinetics of pregnancy. Considering the effects of surgery and anaesthesia on the foetus, only essential and emergency surgeries are performed during pregnancy. Surgical procedures in second trimester have the advantage of better foetal outcome. The primary concerns of maternal and foetal safety are achieved by a focused multidisciplinary team-based approach with respect to the surgical condition...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237596/anaesthetic-management-of-obstetric-emergencies
#3
REVIEW
Pradeep A Dongare, Madagondapalli S Nataraj
Obstetric emergencies are a challenge both for the obstetrician and the anaesthesiologist. The incidence of caesarean sections as per the National Family Health Survey published in 2015-16 was 17.2%. In 7.6% of cases, the decision to conduct a caesarean section was taken after the onset of labour pains. Caesarean sections are classified depending on the urgency into four categories. The target decision to delivery interval for category 1 caesarean section is less than 30 min. This is used as an audit tool for the efficiency of an obstetric service...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30223175/management-and-birth-outcomes-of-pregnant-women-with-chiari-malformations-a-14-years-retrospective-case-series
#4
Joanna C Roper, Bassel H Al Wattar, Adikarige Haritha Dulanka Silva, Shanika Samarasekera, Graham Flint, Alex M Pirie
OBJECTIVE: The management of Chiari malformations in pregnancy is challenging due to the perceived risk of adverse maternal neurological outcomes and raising intracranial pressure during labour. Our aim was to evaluate the management and health outcomes of pregnant women cared for at a regional referral centre and highlight elements of best practice. STUDY DESIGN: A retrospective case series of all pregnant women diagnosed with Chiari malformation over fourteen years (January 2004-June 2018) at the Birmingham Women's Hospital - UK...
November 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/30084204/prevalence-and-prediction-of-higher-estimated-gastric-content-in-parturients-at-full-cervical-dilatation-a-prospective-cohort-study
#5
François-Pierrick Desgranges, Marine Simonin, Sophie Barnoud, Laurent Zieleskiewicz, Eloise Cercueil, Julien Erbacher, Bernard Allaouchiche, Dominique Chassard, Lionel Bouvet
BACKGROUND: Emergent obstetrical procedures may require general anaesthesia in parturients at full cervical dilatation or immediately after vaginal birth. This study aimed to determine the prevalence and the predictive factors of higher estimated gastric content in parturients at full cervical dilatation with epidural analgesia and allowed to drink during the labour, and to assess the ability of the antral area measured in the semirecumbent position (SR-CSA) to identify higher estimated gastric content in this setting...
August 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/30047997/diagnostic-point-of-care-ultrasound-applications-in-obstetric-anaesthetic-management
#6
REVIEW
L Zieleskiewicz, L Bouvet, S Einav, G Duclos, M Leone
Complications during pregnancy are not frequent, but may occur abruptly. Point-of-care ultrasound is a non-invasive, non-ionising diagnostic tool that is available at the bed-side when complications occur. This review covers the use of ultrasound in various clinical situations. Gastric ultrasound can identify stomach contents that put the woman at risk for pulmonary aspiration. In the future, this tool will probably be used routinely before induction of anaesthesia to determine the presence of stomach contents above a particular risk threshold...
October 2018: Anaesthesia
https://www.readbyqxmd.com/read/29935565/an-observational-national-study-of-anaesthetic-workload-and-seniority-across-the-working-week-and-weekend-in-the-uk-in-2016-the-6th-national-audit-project-nap6-activity-survey
#7
H Kemp, S Marinho, T M Cook, L Farmer, M Bellamy, W Egner, S Farooque, K Ferguson, K Floss, T Garcez, S Karanam, J Hitchman, K-L Kong, N McGuire, S Nasser, D N Lucas, M Thomas, H Torevell, A Warner, N J N Harper
BACKGROUND: UK national anaesthetic activity was studied in 2013 but weekend working was not examined. Understanding changes since 2013 in workload and manpower distribution, including weekends, would be of value in workforce planning. METHODS: We performed an observational survey of NHS hospitals' anaesthetic practice in October 2016 as part of the 6th National Audit Project of the Royal College of Anaesthetists (NAP6). All cases cared for by an anaesthetist during the study period were included...
July 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29663461/the-legal-frameworks-that-govern-fetal-surgery-in-the-united-kingdom-european-union-and-the-united-states
#8
REVIEW
Kevin X Cao, Alice Booth, Sebastien Ourselin, Anna L David, Richard Ashcroft
The specialty of fetal surgery or fetal intervention is one of the most exciting emerging fields of modern medicine. It is made possible by decades of major developments in antenatal imaging, obstetric anaesthesia, fetal medicine, paediatric surgery, and of course by the bold and novel practitioners willing to take new steps to advance the field. Beginning in the 1970s, it has now reached a stage of maturity where there are several established in utero procedures and countless clinical trials and studies to develop more...
June 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29313912/complications-in-obstetric-anaesthesia
#9
REVIEW
L Maronge, D Bogod
'Obstetric anaesthesia is a litigious area of medical practice - patient expectations are high, and many of the interventions undertaken by anaesthetists are performed urgently or emergently, frequently out of hours. The complications that occur during obstetric practice are not unique to this area of anaesthesia, but some of the physiological and anatomical changes that take place during pregnancy can affect the frequency with which these happen. In this narrative review, we hope to cover a few of the more common complications in obstetric anaesthesia, as well as some of the more severe, yet less frequently occurring problems...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#10
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29096592/-safe-yet-violent-women-s-experiences-with-obstetric-violence-during-hospital-births-in-rural-northeast-india
#11
Sreeparna Chattopadhyay, Arima Mishra, Suraj Jacob
The majority of maternal health interventions in India focus on increasing institutional deliveries to reduce maternal mortality, typically by incentivising village health workers to register births and making conditional cash transfers to mothers for hospital births. Based on over 15 months of ethnographically informed fieldwork conducted between 2015 and 2017 in rural Assam, the Indian state with the highest recorded rate of maternal deaths, we find that while there has been an expansion in institutional deliveries, the experience of childbirth in government facilities is characterised by obstetric violence...
July 2018: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/29044462/urgency-of-caesarean-section-grading-alarm-chain-and-intrauterine-resuscitation-a-survey-of-scandinavian-practice
#12
K Wildgaard, M Ismaiel, F Hetmann
BACKGROUND: About 40,000 women have caesarean section in Scandinavia each year. Organizational factors for emergency caesarean section (CS), classification, anaesthetic practice, alarm chain, intrauterine resuscitation has all been investigated in the United Kingdom, but no information from the Scandinavian countries exists. METHODS: Using publicly available data from the National Board of Health, obstetric anaesthetic departments were identified. The heads of the departments provided e-mail contact details of two anaesthesiologists regularly practicing obstetric anaesthesia who were then surveyed...
February 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28841636/research-ethics-committee-approval-as-reported-for-abstracts-submitted-to-the-annual-euroanaesthesia-meeting
#13
Paul McConnell, Nechama Kaufman, Stefan De Hert, Charles Marc Samama, Zsolt Molnar, Sharon Einav
BACKGROUND: The annual congress of the European Society of Anaesthesiology (ESA) is one of the largest anaesthesia congresses in the world and exhibits more than 1200 abstracts annually. OBJECTIVES: The aims of this study were to quantify the frequency of inadequate evidence of ethical approval for abstracts submitted to the ESA congress and to examine whether abstracts without appropriate ethical approval were subsequently accepted. DESIGN AND SETTING: All abstracts submitted in 2015 were adjudicated according to European ethical criteria...
December 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28764269/analysis-of-clinical-indicators-of-quality-in-patients-with-endotracheal-intubation
#14
Sulochana Dash, Sreelatha Balasubramanian
INTRODUCTION: Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. AIM: This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28728520/in-and-out-hospital-mortality-rate-in-surgical-patients
#15
Philippe Dony, Magali Pirson, Jean G Boogaerts
BACKGROUND: Death rates after surgery are increasingly analysed for clinical audit and quality assessment. Many studies commonly provide information only on deaths that occur during hospital stay, known as in-hospital death rates. By using hospital data set linked to death certificate registry, we recorded in- and out-hospital deaths within 30 and 60 post-operative days. METHODS: The study included all consecutive surgical procedures (denominator) under general or locoregional anaesthesia in adult patients admitted for elective or non-elective inpatient surgery...
February 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28711179/immediate-birth-an-analysis-of-women-and-their-babies-undergoing-time-critical-birth-in-a-tertiary-referral-obstetric-hospital
#16
M H Warren, J Kamania, A T Dennis
BACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014...
February 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28622635/management-of-parturients-with-factor-xi-deficiency-10year-case-series-and-review-of-literature
#17
REVIEW
Lynda Verghese, Efterpi Tingi, Jecko Thachil, Charles Hay, Louise Byrd
This is an article reviewing the management of pregnant women with factor XI (FXI) deficiency. Retrospective review of the electronic records of 67 pregnancies in 25 women with FXI deficiency over a ten-year period was undertaken. All women received care at St Mary's Tertiary Referral Obstetric/Haematology Clinic for some or all of their pregnancies. Outcome measures included antenatal complications, mode of delivery, anaesthesia provided and postpartum haemorrhage (PPH) and management required. A positive bleeding history was identified in 50% of women prior to pregnancy...
August 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28403414/a-national-survey-of-videolaryngoscopy-in-the-united-kingdom
#18
T M Cook, F E Kelly
Background.: There are increasing numbers of videolaryngoscopes marketed and increasing interest in the technology. The Difficult Airway Society's 2015 guidelines recommend that videolaryngoscopes should be immediately available at all times and that all anaesthetists should be trained and skilled in their use. Methods.: An electronic survey was sent to all UK National Health Service hospitals to examine availability, use, and attitudes to videolaryngoscopy, and closed in January 2014...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28377839/comparison-of-patient-satisfaction-between-general-and-spinal-anaesthesia-in-emergency-caesarean-deliveries
#19
Arzu Açıkel, Tülün Öztürk, Aslı Göker, Gonca Gül Hayran, Gönül Tezcan Keleş
OBJECTIVE: Obstetric anaesthesia aims to deliver a healthy baby as well as render a comfortable operation for the mother. This study compared general and spinal anaesthesia in terms of the quality of recovery and patient satisfaction in women undergoing emergency caesarean deliveries. METHODS: In total, 100 patients were enrolled in this prospective, single-blind, cross-sectional clinical study. Patients were divided into spinal (n=50) and general (n=50) anaesthesia groups...
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#20
REVIEW
Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
June 2017: Current Opinion in Anaesthesiology
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