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Obstetric anaesthesia

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https://www.readbyqxmd.com/read/29663461/the-legal-frameworks-that-govern-fetal-surgery-in-the-united-kingdom-european-union-and-the-united-states
#1
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...
April 16, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29576118/association-between-mode-of-anaesthesia-and-severe-maternal-morbidity-during-admission-for-scheduled-caesarean-delivery-a-nationwide-population-based-study-in-japan-2010-2013
#2
H Abe, M Sumitani, K Uchida, T Ikeda, H Matsui, K Fushimi, H Yasunaga, Y Yamada
BACKGROUND: Although the incidence of maternal mortality during Caesarean delivery remains very low, the rate of severe maternal morbidity is increasing. Improvements in obstetric anaesthetic practice have resulted in a dramatic reduction in the risk of maternal death from general anaesthesia. Less clear is whether the risk of severe maternal morbidity differs according to mode of anaesthesia for women undergoing Caesarean delivery. We analysed the association between the mode of anaesthesia and severe maternal morbidity during Caesarean delivery using a nationally representative inpatient database...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29547425/are-short-subspecialty-courses-the-educational-answer
#3
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29507022/pregnancy-in-a-patient-with-portal-hypertension-secondary-to-liver-cirrhosis
#4
Faith Jelagat Lelei-Mailu, Charles Muriuki Mariara
This case report is of a 32-year-old woman of African descent on follow-up for pregnancy in the background of portal hypertension due to liver cirrhosis. She had initially been treated for chronic hepatitis B infection with lamivudine and tenofovir, complicated by portal hypertension and variceal bleeding that thrice required banding. Her pregnancy was uneventful until 31 weeks gestation when she presented with dyspnoea. On examination and investigation, she had oedema, bilateral pleural effusions and ascites...
March 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29461008/propofol-exposure-during-early-gestation-impairs-learning-and-memory-in-rat-offspring-by-inhibiting-the-acetylation-of-histone
#5
Jiamei Lin, Shengqiang Wang, Yunlin Feng, Weihong Zhao, Weilu Zhao, Foquan Luo, Namin Feng
Propofol is widely used in clinical practice, including non-obstetric surgery in pregnant women. Previously, we found that propofol anaesthesia in maternal rats during the third trimester (E18) caused learning and memory impairment to the offspring rats, but how about the exposure during early pregnancy and the underlying mechanisms? Histone acetylation plays an important role in synaptic plasticity. In this study, propofol was administered to the pregnant rats in the early pregnancy (E7). The learning and memory function of the offspring were tested by Morris water maze (MWM) test on post-natal day 30...
February 20, 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29378991/postoperative-analgesia-using-bupivacaine-wound-infiltration-with-intravenous-tramadol-or-dexamethasone-following-obstetric-spinal-anaesthesia
#6
N P Edomwonyi, M O Osazuwa, O I Iribhogbe, S E Esangbedo
CONTEXT: Effective management of postcesarean section (CS) pain is important for the well-being of mother and child; even in limited-resource areas, there are drug options which can be explored to achieve this. AIM: This study aimed to compare the analgesic effects of a combination of bupivacaine wound infiltration with either intravenous (IV) dexamethasone or tramadol after CS. SETTING AND DESIGN: This study was a randomized, double-blind, comparative study in a tertiary hospital...
December 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29361254/high-flow-humidified-nasal-oxygen-in-pregnant-women
#7
Pcf Tan, A T Dennis
Failed airway management in the obstetric patient undergoing general anaesthesia is associated with major sequelae for the mother and/or fetus. Effective and adequate pre-oxygenation is an important safety strategy and a recommendation in all current major airway guidelines. Pre-oxygenation practice in the obstetric population may be suboptimal based on current literature. Recently, clinical applications for high flow nasal oxygen, also known as transnasal humidified rapid insufflation ventilatory exchange or THRIVE, are expanding in the non-obstetric population and may have theoretical benefits if used for pre-oxygenation and apnoeic oxygenation in the obstetric population...
January 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29343042/harlequin-syndrome-as-a-rare-complication-after-epidural-anaesthesia-in-an-obstetric-patient
#8
Juan M Redondo, María Rivas, María L Martín, María D Torrado, María J Rodríguez
No abstract text is available yet for this article.
January 17, 2018: Minerva Anestesiologica
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/29295777/hereditary-haemorrhagic-telangiectasia-in-pregnancy-regional-and-general-anaesthesia
#10
M Crawford, R Burns, S Cooper, T Mackay
Hereditary haemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is a rare autosomal dominant multisystem disorder, characterised by mucocutaneous telangiectases and arteriovenous malformations affecting any organ. The physiological changes in pregnancy pose significant obstetric and anaesthetic challenges for women affected by the disease. The optimal timing and mode of delivery requires careful consideration; and the benefits and risks of both regional and general anaesthetic techniques must be carefully considered, depending on the organs affected...
February 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29288922/a-prospective-study-of-the-frequency-of-severe-pain-and-predictive-factors-in-women-undergoing-first-trimester-surgical-abortion-under-local-anaesthesia
#11
Solène Duros, Yolaine Joueidi, Krystel Nyangoh Timoh, Laurence Boyer, Paul Lemeut, Aude Tavenard, Bruno Laviolle, Jean Levêque, Vincent Lavoué
OBJECTIVE: To determine the frequency of severe pain among women and to identify the associated predictive factors during first-trimester surgical abortion under local anaesthesia (LA). STUDY DESIGN: A prospective cohort study from November 2013 to January 2014 at the Department of Gynecology and Obstetrics, Rennes, France. The study population was composed of one hundred and ninety-four patients who underwent an elective first-trimester surgical abortion under LA...
February 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29246560/transvaginal-natural-orifice-transluminal-endoscopic-surgery-a-new-approach-to-ovarian-cystectomy
#12
Jan Baekelandt
OBJECTIVE: To demonstrate a new approach for performing an ovarian cystectomy via transvaginal natural orifice transluminal endoscopic surgery (vNOTES) as an alternative for a laparoscopic ovarian cystectomy. DESIGN: Stepwise explanation of the technique using original video footage. SETTING: Hospital. PATIENT(S): Fourteen patients who provided informed consent and were treated transvaginally to remove a benign ovarian cyst...
February 2018: Fertility and Sterility
https://www.readbyqxmd.com/read/29225948/collecting-data-for-global-surgical-indicators-a-collaborative-approach-in-the-pacific-region
#13
REVIEW
Glenn Douglas Guest, Elizabeth McLeod, William R G Perry, Vilami Tangi, Joao Pedro, Ponifasio Ponifasio, Johnny Hedson, Jemesa Tudravu, Douglas Pikacha, Eric Vreede, Basil Leodoro, Noah Tapaua, James Kong, Bwabwa Oten, Deacon Teapa, Stephanie Korin, Leona Wilson, Samson Mesol, Kabiri Tuneti, John G Meara, David A Watters
In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enable countries to measure their surgical and anaesthesia care delivery. These indicators have subsequently been accepted by the World Bank for inclusion in the World Development Indicators. With support from the Royal Australasian College of Surgeons and the Pacific Islands Surgical Association, 14 South Pacific countries collaborated to collect the first four of six LCoGS indicators. Thirteen countries collected all four indicators over a 6-month period from October 2015 to April 2016...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#14
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
#15
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
#16
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-years-of-litigation-for-pain-during-caesarean-section
#17
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...
February 2018: 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
#18
EDITORIAL
J P Campbell, G M Stocks
No abstract text is available yet for this article.
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29077820/obstetric-neuraxial-anaesthesia-in-the-context-of-maternal-immune-thrombocytopenia-secondary-analysis-of-a-retrospective-cohort-study
#19
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
#20
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
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