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Obstetric anaesthesia

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https://www.readbyqxmd.com/read/28321296/improving-surgical-and-anaesthesia-practice-review-of-the-use-of-the-who-safe-surgery-checklist-in-felege-hiwot-referral-hospital-ethiopia
#1
Ryan Ellis, Ahmad Izzuddin Mohamad Nor, Iona Pimentil, Zebenaye Bitew, Jolene Moore
Development of surgical and anaesthetic care globally has been consistently reported as being inadequate. The Lancet Commission on Global Surgery highlights the need for action to address this deficit. One such action to improve global surgical safety is the introduction of the WHO Surgical Checklist to Operating Rooms (OR) around the world. The checklist has a growing body of evidence supporting its ability to assist in the delivery of safe anaesthesia and surgical care. Here we report the introduction of the Checklist to a major Ethiopian referral hospital and low-resource setting and highlight the success and challenges of its implementation over a one year period...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#2
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...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28275833/survey-of-emergency-and-essential-surgical-obstetric-and-anaesthetic-services-available-in-bangladeshi-government-health-facilities
#3
Jonathan Loveday, Sonal P Sachdev, Meena N Cherian, Francisco Katayama, A K M Akhtaruzzaman, Joe Thomas, N Huda, E Brian Faragher, Walter D Johnson
OBJECTIVE: Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. METHODS: Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies...
March 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28255987/a-randomised-double-blind-trial-of-phenylephrine-and-metaraminol-infusions-for-prevention-of-hypotension-during-spinal-and-combined-spinal-epidural-anaesthesia-for-elective-caesarean-section
#4
N J McDonnell, M J Paech, N A Muchatuta, S Hillyard, E A Nathan
Prophylactic vasopressor administration is commonly recommended to reduce maternal hypotension during spinal anaesthesia for caesarean section. Metaraminol has undergone limited investigation in obstetric anaesthesia for this purpose, particularly in comparison with phenylephrine. In this multicentre, randomised, double-blind, non-inferiority study, we compared prophylactic phenylephrine or metaraminol infusions, started immediately after spinal anaesthesia, in 185 women who underwent elective caesarean section...
March 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28178769/improving-post-caesarean-analgesia-where-to-next
#5
A Butwick
No abstract text is available yet for this article.
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#6
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
https://www.readbyqxmd.com/read/28153548/neonatal-and-maternal-outcomes-of-pregnancy-with-maternal-cardiac-disease-the-normandy-study-%C3%A2-years-2000-2014
#7
Vincent Bonnet, Thérèse Simonet, Fabien Labombarda, Patricia Dolley, Paul Milliez, Michel Dreyfus, Jean-Luc Hanouz
Pregnancies complicated by congenital or acquired heart diseases are at high risk of maternal, obstetrical and neonatal poor outcomes. During the period 2000-2014, 197 pregnancies occurring in 147 women with heart disease were managed in our institution. A maternal cardiac event complicated 13 pregnancies. Obstetrical and neonatal complications occurred respectively in 35.0% (95% CI [28.3-41.7]) and 37.0% (95% CI [30.3-43.7]) of pregnancies. All complications were more frequent amongst cardiomyopathies or obstructive and conotruncal lesions, whereas left-to-right shunts were less prone to present with complications...
January 30, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28070884/a-national-survey-of-neurological-monitoring-practice-after-obstetric-regional-anaesthesia-in-the-uk
#8
E Roderick, J Hoyle, S M Yentis
Neuraxial anaesthesia is widely used in obstetrics and neurological complications are rare. However, when they occur, subsequent investigation and management are time-critical and correlate with the extent of neurological recovery. The Third National Audit Project recommended the implementation of guidelines in obstetric epidural management, including advice on monitoring for early signs of problems and acting upon concerns. However, no national guideline exists for postoperative management in the obstetric population...
January 10, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#9
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27986182/episiotomy-technique-and-management-of-anal-sphincter-tears-a-survey-of-clinical-practice-and-education
#10
Rebecca Menzies, Marian Leung, Nirmala Chandrasekaran, Andrea Lausman, Michael Geary
OBJECTIVE: To ascertain current techniques of episiotomy used by obstetrics and gynaecology faculty members and residents in an academic department and to determine the current management strategies for third and fourth degree tears. METHOD: A 14-question anonymous online survey was circulated to all faculty members and residents in the University of Toronto Department of Obstetrics and Gynaecology between October 2015 and March 2016. Results were analyzed descriptively or with Fisher exact test...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27969554/obstetric-and-anaesthesia-checklists-for-the-management-of-morbidly-adherent-placenta
#11
Melissa G Walker, Lindsay Pollard, Chiraag Talati, Jose C A Carvalho, Lisa M Allen, John Kachura, Ally Murji, John C Kingdom, Rory Windrim
OBJECTIVE: To develop an integrated checklist for the management of patients with suspected morbidly adherent placenta (MAP). METHODS: A checklist process was developed incrementally by clinicians in the disciplines of maternal-fetal medicine, gynaecology, medical imaging, and anaesthesia for management of women with suspected MAP. RESULTS: Over a five-year period of debriefing after individual cases, a comprehensive checklist system was developed...
November 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27956674/patient-reported-outcome-of-adult-perioperative-anaesthesia-in-the-united-kingdom-a-cross-sectional-observational-study
#12
E M K Walker, M Bell, T M Cook, M P W Grocott, S R Moonesinghe
BACKGROUND: Understanding the patient perspective on healthcare is central to the evaluation of quality. This study measured selected patient-reported outcomes after anaesthesia in order to identify targets for research and quality improvement. METHODS: This cross-sectional observational study in UK National Health Service hospitals, recruited adults undergoing non-obstetric surgery requiring anaesthesia care over a 48 h period. Within 24 h of surgery, patients completed the Bauer questionnaire (measuring postoperative discomfort and satisfaction with anaesthesia care), and a modified Brice questionnaire to elicit symptoms suggestive of accidental awareness during general anaesthesia (AAGA)...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27904165/a-retrospective-perinatal-data-analysis-of-immigrant-and-german-women-from-representative-birth-cohorts-at-the-virchow-hospital-berlin
#13
R Armbrust, R von Rennenberg, M David
Introduction: The aim of this study was to define and characterise differences in the level of obstetric care provided to immigrant and German women. Materials and Methods: An analysis of the Virchow Hospital's birth registers was conducted for the years 1974, 1984 and 1994. The study population of 5445 patients was grouped according to ancestry/family origin on the basis of a name analysis, and subsequently also according to parity (primiparous or multiparous). On name analysis 2741 women were defined as German, 1598 were grouped as women of Turkish origin and 810 as immigrants of other origin...
November 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27897027/-acute-uterine-inversion-after-delivery
#14
E Pechová, I Bydžovská, M Krausová, M Lubušký
OBJECTIVE: A case of acute inversion of the uterus after childbirth, in which we successfully perform a manual vaginal reposition of the uterus. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Krajská nemocnice Liberec, a.s.; Department of Obstetrics and Gynaecology, Palacky University Hospital, Olomouc. OBSERVATION: Our case report describes acute post-partum uterine inversion of the second degree, which developed after delivery in a 36-year-old primigravida...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27829879/hermansky-pudlak-syndrome-in-pregnancy-a-case-report
#15
Lydia Yusuf, Srivasavi Dukka, Etienne Ciantar
Hermansky-Pudlak syndrome is a rare autosomal recessive disorder estimated to affect 1 in 500,000 to 1,000,000 individuals worldwide. Clinically, it presents as oculocutaneous albinism combined with bleeding diathesis. This is due to the absence of dense bodies in platelets causing a delayed secondary response resulting in prolonged bleeding time despite normal platelet count and coagulation factors. This has consequences for major bleeding, the risk of which is high at delivery. In the longer term, the condition is also associated with the development of pulmonary fibrosis, inflammatory bowel disorders caused by granulomatous colitis and renal failure...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27738833/measuring-the-burden-of-surgical-disease-averted-by-emergency-and-essential-surgical-care-in-a-district-hospital-in-papua-new-guinea
#16
Matthew A R Stokes, Glenn D Guest, Perista Mamadi, Westin Seta, Noel Yaubihi, Grace Karawiga, Billy Naidi, David A K Watters
BACKGROUND: Timely access to emergency and essential surgical care (EESC) and anaesthesia in low- and middle-income countries (LMICs) prevents premature death, minimises lifelong disability and reduces their economic impact on families and communities. Papua New Guinea is one of the poorest countries in the Pacific region, and provides much of its surgical care at a district hospital level. We aimed to evaluate the surgical capacity of a district hospital in PNG and estimate the effectiveness of surgical interventions provided...
October 13, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27726918/anaesthetic-management-of-parturients-with-univentricular-congenital-heart-disease-and-the-fontan-operation
#17
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27717633/failure-of-communication-a-patient-s-story
#18
Susanna E R Stanford, David G Bogod
The first author, a patient who underwent elective caesarean section and felt pain necessitating conversion to general anaesthesia, describes the experience with particular reference to the perceived poor communication between her and her anaesthetist. This extended from the preoperative visit to the information provided to her general practitioner after discharge. She makes several suggestions which would have made her experience, and those of other patients in similar circumstances, less traumatic. The second author, who had no involvement in events and works in a different Trust, comments upon the events from the perspective of an obstetric anaesthetist...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27716155/specialty-preferences-among-final-year-medical-students-in-medical-schools-of-southeast-nigeria-need-for-career-guidance
#19
Edmund Ndudi Ossai, Kenechi Anderson Uwakwe, Uchenna Chidi Anyanwagu, Ntat Charles Ibiok, Benedict Ndubueze Azuogu, Ngozi Ekeke
BACKGROUND: In resource-poor settings with low doctor-population ratio, there is need for equitable distribution of healthcare workforce. The specialty preferences of medical students determine the future composition of physician workforce hence its relevance in career guidance, healthcare planning and policy formulation. This study was aimed at determining the specialty preferences of final year medical students in medical schools of southeast Nigeria, the gender differences in choice of specialty and the availability of career guidance to the students during the period of training...
October 4, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27666754/obstetrical-transfusion-medicine-knowledge-among-faculty-and-trainee-obstetricians-a-prospective-knowledge-assessment-study
#20
S Morris, M H Yudin, J Callum, A Alam, J Herold, Y Lin
OBJECTIVES: To evaluate the current state of transfusion medicine (TM) knowledge among obstetricians using a valid assessment tool. BACKGROUND: Transfusion issues are common in obstetrical patients. METHODS: Knowledge topics were identified and rated by experts in obstetrics, anaesthesia, haematology and TM using a modified Delphi method. A knowledge assessment tool was developed and validated during pilot testing. The assessment tool, consisting of 15 multiple choice questions, was administered electronically to members of the Society of Obstetricians and Gynaecologists of Canada (SOGC)...
December 2016: Transfusion Medicine
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