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Obstetric anaesthesia

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https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#1
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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
#2
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
#3
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...
November 3, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/29090735/learning-from-the-law-a-review-of-21%C3%A2-years-of-litigation-for-pain-during-caesarean-section
#4
K McCombe, D G Bogod
The large majority of caesarean sections in the UK are now carried out under neuraxial anaesthesia. Although this technique is widely accepted as being the safest option in most circumstances, the use of regional anaesthesia increases the risk of patients experiencing intra-operative discomfort or pain. Pain during operative obstetric delivery is the commonest successful negligence claim relating to regional anaesthesia against obstetric anaesthetists in the UK. In the following article, using a database of over 360 cases spanning 21 years, we break down and examine the recurrent components of medicolegal claims concerning pain during caesarean section and consider how anaesthetists might avoid litigation...
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29090732/management-of-hypotension-with-vasopressors-at-caesarean-section-under-spinal-anaesthesia-have-we-found-the-holy-grail-of-obstetric-anaesthesia
#5
EDITORIAL
J P Campbell, G M Stocks
No abstract text is available yet for this article.
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29077820/obstetric-neuraxial-anaesthesia-in-the-context-of-maternal-immune-thrombocytopenia-secondary-analysis-of-a-retrospective-cohort-study
#6
A K Malinowski, B De France, D Sun, J C A Carvalho, N Shehata
No abstract text is available yet for this article.
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29070618/successful-obstetric-and-anaesthetic-management-of-a-pregnant-woman-with-achondroplasia
#7
Rauf Melekoglu, Ebru Celik, Sevil Eraslan
Achondroplasia is the most prevalent form of dwarfism, and there is little evidence about the optimal management of pregnant women with achondroplasia. We presented a 25-year-old primigravid woman with achondroplasia who was followed up during the pregnancy period and performed elective caesarean section with combined spinal-epidural anaesthesia at the 38th week of gestation. Frequent obstetric follow-up visits and invasive prenatal diagnostic tests should be offered during the antenatal period due to the increased risk for obstetric complications, such as premature delivery and fetal anomalies...
October 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29062547/myasthaenia-gravis-clinical-management-issues-before-during-and-after-pregnancy
#8
REVIEW
Ali Hassan, Zakia M Yasawy
Myasthaenia gravis (MG) is an autoimmune neuromuscular disorder which is twice as common among women, often presenting in the second and third decades of life. Typically, the first trimester of pregnancy and first month postpartum are considered high-risk periods for MG exacerbations. During pregnancy, treatment for MG is usually individualised, thus improving its management. Plasma exchange and immunoglobulin therapies can be safely used to treat severe manifestations of the disease or myasthaenic crises. However, thymectomies are not recommended because of the delayed beneficial effects and possible risks associated with the surgery...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#9
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the Society for Obstetric Anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29044462/urgency-of-caesarean-section-grading-alarm-chain-and-intrauterine-resuscitation-a-survey-of-scandinavian-practice
#10
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...
October 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29034449/nitrous-oxide-based-vs-nitrous-oxide-free-general-anaesthesia-and-accidental-awareness-in-surgical-patients-an-abridged-cochrane-systematic-review
#11
REVIEW
J Hounsome, J Greenhalgh, O J Schofield-Robinson, S R Lewis, T M Cook, A F Smith
Accidental awareness during general anaesthesia can arise from a failure to deliver sufficient anaesthetic agent, or from a patient's resistance to an expected sufficient dose of such an agent. Awareness is 'explicit' if the patient is subsequently able to recall the event. We conducted a systematic review into the effect of nitrous oxide used as part of a general anaesthetic on the risk of accidental awareness in people over the age of five years undergoing general anaesthesia for surgery. We included 15 randomised controlled trials, 14 of which, representing a total of 3439 participants, were included in our primary analysis of the frequency of accidental awareness events...
October 16, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29029368/who-accesses-surgery-at-district-level-in-sub-saharan-africa-evidence-from-malawi-and-zambia
#12
Jakub Gajewski, Rachel Dharamshi, Michael Strader, John Kachimba, Eric Borgstein, Gerald Mwapasa, Mweene Cheelo, Tracey McCauley, Leon Bijlmakers, Ruairi Brugha
OBJECTIVES: To examine age and gender distribution for the most common types of surgery in Malawi and Zambia. METHODS: Data were collected from major operating theatres in 8 district hospitals in Malawi and 9 in Zambia. Raw data on surgical procedures were coded by specialist surgeons for frequency analyses. RESULTS: In Malawi, female surgical patients had a mean age of 25 years, with 91% aged 16-40 years. Females accounted for 85%, and obstetric cases for 75%, of all surgical patients...
October 13, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29025452/management-of-failed-spinal-anaesthesia-for-caesarean-section
#13
Gavin Wyndham Jones, Raphael Anthony Samuel, Bruce McClure Biccard
BACKGROUND: Failed spinal anaesthesia for caesarean section (CS) may be partial or complete and the subsequent discomfort is the most commonly cited cause of litigation in obstetric anaesthesia. OBJECTIVES: To determine if there is a standardised approach to: (i) testing the level of block of spinal anaesthesia; and (ii) the management of failed spinal anaesthesia for CS. METHODS: A structured questionnaire to ascertain the current practice of testing the level of block and management of three different scenarios of failed spinal anaesthesia was distributed to 51 government hospitals in KwaZulu-Natal, South Africa (SA)...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28969337/reply-to-lucas-and-vaughan-videolaryngoscopy-and-obstetric-anaesthesia
#14
F E Kelly, T M Cook
No abstract text is available yet for this article.
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28969336/videolaryngoscopy-and-obstetric-anaesthesia
#15
D N Lucas, D J A Vaughan
No abstract text is available yet for this article.
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28899733/paralysis-analysis-does-choice-of-muscle-relaxant-for-obstetric-general-anaesthesia-influence-neonatal-outcomes
#16
EDITORIAL
M Rucklidge
No abstract text is available yet for this article.
November 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28874243/central-regional-anaesthesia-in-patients-with-aortic-stenosis-a-systematic-review
#17
Sofia Johansson, Morten Nikolaj Lind
INTRODUCTION: Aortic stenosis is a valvular lesion that poses several haemodynamic challenges for the anaesthesiologist. The use of central regional anaesthesia is traditionally regarded as contraindicated in patients with severe aortic stenosis due to its sympatholytic effect, potentially causing loss of vascular tone and ultimately diminished cardiac output. The aim of this paper was to review current literature to find evidence for or against the use of neuroaxial blockade in patients with aortic stenosis...
September 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28841636/research-ethics-committee-approval-as-reported-for-abstracts-submitted-to-the-annual-euroanaesthesia-meeting
#18
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/28827247/comparing-provision-and-appropriateness-of-health-care-between-immigrants-and-non-immigrants-in-germany-using-the-example-of-neuraxial-anaesthesia-during-labour-cross-sectional-study
#19
Oliver Razum, Katharina Reiss, Jürgen Breckenkamp, Lutz Kaufner, Silke Brenne, Kayvan Bozorgmehr, Theda Borde, Matthias David
OBJECTIVE: Research on health services for immigrants has mostly been concerned with access barriers but rarely with appropriateness and responsiveness of care. We assessed whether appropriateness and responsiveness of care depend on migration status, using provision of neuraxial anaesthesia (NA) during labour as indicator. In relation to their migration status, we analysed whether (1) women undergoing elective or secondary/urgent secondary caesarean sections (ESCS) appropriately receive NA (instead of general anaesthesia), (2) women delivering vaginally appropriately receive NA and (3) women objecting to NA, for example, for religious reasons, may deliver vaginally without receiving NA (provider responsiveness)...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28766691/risk-factors-for-peripheral-nerve-injuries-following-neuraxial-labour-analgesia-a-nested-case-control-study
#20
G Haller, I Pichon, F-O Gay, G Savoldelli
BACKGROUND: Post-partum lower extremity motor and sensory dysfunctions occur in 0.1-9.2‰ of deliveries. While macrosomia, lithotomy position and forceps use are well-identified causes of peripheral nerve injuries, additional contributors such as patient condition and anaesthesia care may also have to be considered. METHODS: We performed a case-control study nested in a cohort of 19,840 patients having neuraxial anaesthesia for childbirth. Cases were all patients who developed motor or sensory dysfunction of lower extremities in the post-partum period...
October 2017: Acta Anaesthesiologica Scandinavica
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