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peridural obstetr

Maximiliaan van Erp, Clemens Ortner, Stefan Jochberger, Klaus Ulrich Klein
The following article contains information not only for the clinical working anaesthesiologist, but also for other specialists involved in obstetric affairs. Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus...
November 2017: Wiener Medizinische Wochenschrift
B Vavrinková, T Binder, J Horák
OBJECTIVE: Comparison between particular methods of obstetrics analgesia, their analgetic efects and influence on progress of delivery and postpartum adaptation of fetus. DESIGN OF THE STUDY: Prospective study. SETTING: The Department of Gynecology and Obstetrics of the Teaching Hospital and the 2nd Medical Faculty of the Charles University in Prague. METHODS: A prospective study of 644 patients who received intravenous increments of nalbuphine (196 women) or epidural analgesia (217 women) or pethidin (231 women)...
December 2010: Ceská Gynekologie
P Kranke, T Annecke, D H Bremerich, R Hanß, L Kaufner, C Klapp, H Ohnesorge, U Schwemmer, T Standl, S Weber, T Volk
Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology...
January 2016: Der Anaesthesist
Cornelia Bachmann, Harald Abele, Diethelm Wallwiener, Karl Oliver Kagan
INTRODUCTION: Challenges of modern medicine are peripartum bleeding complications as one of the most frequent cases of emergency in obstetrics with a prevalence of 0.5-5.0 %, meaning the main cause of maternal morbidity and mortality. In this context, inherited diseases such as Hermansky-Pudlak syndrome (HPS) should be recognized. HPS is a rare disease and belongs to a heterogeneous group of autosomal recessive disorders characterized by the triad of partial oculocutaneous albinism, disorder of "ceroid" metabolism and platelet storage pool deficiency with bleeding disorder...
June 2014: Archives of Gynecology and Obstetrics
Marcela Amparo Osuna-Zazueta, Francisco Javier Jaime-Alejo, Iván Pérez-Neri
Pain during labor alters the well-being of the mother and fetus. Peridural analgesia may prevent pain, but some physicians prefer to administrate this until labor has progressed in order to avoid blocking labor so a cesarean surgery would be required. In this case, the mother suffers pain until labor has progressed enough to apply analgesia. Thus, the mother suffers pain while labor has progressed enough. Cesarean surgery increases maternal morbidity, thus it is important to evaluate labor progression when analgesia is applied at an early or advanced stage of labor...
November 2013: Gaceta Médica de México
Rossana Cecchi, Paola Frati, Oriana Capri, Luigi Cipolloni
Sudden death following acute hypotension due to an undiagnosed pheochromocytoma (PHEO) is a rare event. Moreover, histopathology of the myocardium in such cases is rarely reported. We present a case of a woman who died during delivery. A 37-year-old parturient, who was 38 weeks pregnant, suffering from neurofibromatosis underwent a cesarean section following peridural anesthesia. Acute hypotension, acute intra-operative pulmonary edema and supraventricular paroxysmal tachyarrhythmia occurred during delivery, followed by death...
November 2013: Journal of Forensic Sciences
B Löser, S Tank, G Hillebrand, B Goldmann, W Diehl, D Biermann, J Schirmer, D A Reuter
Peripartum cardiomyopathy (PPCM) is a rare type of heart failure which presents towards the end of pregnancy or in the first 5 months after delivery. Depending on the geographical location the incidence is reported in the literature as 1:300 up to 1:15,000. There are a number of known risk factors, such as multiparity and age of the mother over 30 years. The symptoms of PPCM correspond to those of idiopathic cardiomyopathy. The diagnosis is mainly carried out using echocardiography which shows a clear reduction of systolic left ventricular function...
May 2013: Der Anaesthesist
J-L Hanouz, T Simonet, C Marliot, A Mayaud, A Girard, N Rakotnirina, J-L Fellahi, J-L Gérard
OBJECTIVES: The last French survey on alternatives to neuraxial anaesthesia for labour pain was published in 1997. However, intravenous remifentanil has become increasingly used as an option for labour analgesia. We evaluated the use of remifentanil as an alternative to epidural analgesia in level 2 and 3 French maternities in 2009. STUDY DESIGN: This was an internet-based French survey performed in 2009 including all level 2 and 3 maternities. Data recorded were maternity unit characteristic, alternatives to neuraxial analgesia used, and remifentanil administration protocols...
September 2012: Annales Françaises D'anesthèsie et de Rèanimation
A De Jong, L Benayoun, Y Bekrar, S Forget, A Wernet
Prevalence of cerebral cavernous malformations is comprised in between 0.4 to 0.8% of the people. Anesthetic management of pregnant women suffering from this disease is often difficult. We have witnessed two cases of delivery concerning two patients suffering from a cerebral cavernous malformation, one with vaginal delivery under peridural analgesia and the other one with cesarean delivery under rachianesthesia. We recommend the realization of a magnetic resonance imaging the year before delivery. Without medullar cavernous malformations, perimedullar analgesia seems to be the preferred method of choice...
July 2012: Annales Françaises D'anesthèsie et de Rèanimation
P Deruelle
Obesity during pregnancy increases the risk of complications for both the mother (gestational hypertension, diabetes mellitus) and the newborn (malformations and macrosomia). Deliveries are also more difficult with more c-section and failure in peridural analgesia. A specific organization supported by the perinatal network should improve the management of these women, especially for morbid obesity.
February 2011: Gynécologie, Obstétrique & Fertilité
Sophie Dupont
The enzyme-inducing antiepileptic drugs such as carbamazepine, phenytoin, barbiturates, oxcarbazepine do not allow oral contraceptives. The pregnancy must be planned. Every patient in childbearing age should be informed by her practitioner. The rule is to optimize the antiepileptic treatment before the pregnancy: less drugs, less dosages. This optimization will depend on the epileptic syndrome and the nature of the treatment. Valproate of sodium should be avoided, if possible, during pregnancy. Preconceptional supplementation by folic acid should be considered...
March 2011: La Presse Médicale
Jean-Philippe Neau, Pauline Marion, Stéphane Mathis, Adrien Julian, Gaëlle Godeneche, Delphine Larrieu, Jean-Claude Meurice, Joël Paquereau, Pierre Ingrand
AIMS: To describe the frequency of restless legs syndrome (RLS) in a French population of randomly selected women during their third trimester of pregnancy and its evolution up to 3 months after delivery and to identify potential factors associated with the improvement of RLS after delivery. METHODS: A cross-sectional questionnaire survey. RESULTS: 186 pregnant women living in a French town were included. 32% of women were affected by RLS during the third trimester of their pregnancy...
2010: European Neurology
Márcio Antonio de Souza, João Luiz Pinto e Silva, Nelson Lourenço Maia Filho
PURPOSE: To compare maternal and perinatal results, after the use of continuous peridural versus combined rachidian and peridural analgesia in primiparous parturients. METHODS: Randomized clinical trial with 128 primiparous pregnant women in labor, divided into two groups: peridural analgesia (CPA) with 65 women, and combined continuous rachidian and peridural analgesia (CRPA) with 63, all of them admitted in the pre-labor period at two maternities in Jundiai, in the state of São Paulo...
October 2009: Revista Brasileira de Ginecologia e Obstetrícia
P Hanusch, J Heyn, H Well, E Weninger, U Hasbargen, M Rehm
Friedreich's ataxia (FA) is a hereditary disease, which leads to degenerative changes in the spinal cord and cerebellum (incidence 1:50,000). These changes are caused by a defect in the gene that encodes a mitochondrial gene called frataxin and causes muscle weakness, scoliosis, cardiomyopathy and impaired glucose tolerance. Therefore, these patients require special care during anaesthesia. We report the case of a 25-year-old primigravida with a history of FA and dorsal stabilisation of the vertebral column, who was admitted to our hospital for elective caesarean section...
July 2009: Der Anaesthesist
No abstract text is available yet for this article.
August 1948: Rhode Island Medical Journal
Elaine Christine Dantas Moisés, Luciana de Barros Duarte, Ricardo de Carvalho Cavalli, Maria Paula Marques, Vera Lúcia Lanchote, Geraldo Duarte, Sérgio Pereira da Cunha
BACKGROUND: Peridural blockade with lidocaine, bupivacaine, and fentanyl is an anesthetic procedure extensively used in obstetrics, justifying the pharmacokinetic study of these drugs during labor. OBJECTIVE: To investigate the influence of the physiopathological changes of gestational diabetes mellitus (GDM) on the pharmacokinetics of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in pregnant women subjected to peridural anesthesia. PATIENTS AND METHODS: Ten normal pregnant women (group 1) and six pregnant women with GDM (group 2) were studied, all of them at term...
December 2008: European Journal of Clinical Pharmacology
Birgit Arabin, Karel Kuizenga, Diny van Zoeren, Diny V Zveren, Jim V Eyck
We report on an exceptional therapy with epidural anesthesia and tunnelling of the peridural catheter over a time period of 2-14 days in patients with threatening early preterm labor, intact membranes and vaginal engagement of the infants (4 singleton, 8 twin and 2 triplet pregnancies). A combination of bupivacaine (0.125%) and fentanyl (2 microg/mL) was used up to a maximum of 20 mL/h during the treatment period. Long-term follow-up of the infants was normal in 19/20 infants. The advantages, such as prolongation of pregnancy without maternal pain and disadvantages such as the risk of fetal and maternal infection and of sudden delivery are discussed...
2008: Journal of Perinatal Medicine
H Pagès, B de la Gastine, J Quedru-Aboane, M-G Guillemin, V Lelong-Boulouard, B Guillois
Pudendal nerve block may be indicated during instrumental delivery in situations where peridural anesthesia is unavailable. We report three cases of neonatal lidocaine intoxication following maternal pudendal block during delivery. Clinical features were hypotonia, pupillary mydriasis fixed to light, apnea, cyanosis and seizures. Two neonates required mechanical ventilation. Lidocaine was found in the serum of two babies. In all three cases, recovery was complete. The pharmacokinetics of lidocaine in a highly vascularized perineum during labor increase the risk of neonatal intoxication...
June 2008: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
No abstract text is available yet for this article.
March 1949: Current Researches in Anesthesia & Analgesia
A F Ouro-Bang'Na Maman, N Agbétra, A Djibril, P Egbohou, N Kangni, K Tomta, K Akpadza, S Ahouangbévi, M Chobli
The purpose of this study was to evaluate knowledge and acceptance of obstetric peridural analgesia among pregnant women in Togo. A prospective, descriptive survey was carried out over a period of one month. A standardized survey form was used to collect data. A total of 303 pregnant women with a mean age of 27 +/- 6 years were interviewed. A proportion of primiparous and multiparous was the same, i.e., 50%. Among multiparous women, 83.5% described labor pain during previous deliveries as severe. Twelve percent of the pregnant women interviewed claimed knowledge of techniques to control labor pain...
April 2007: Médecine Tropicale: Revue du Corps de Santé Colonial
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