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Obstetrics; hemodynamics

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https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#1
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28061522/placental-transfusion-strategies-in-italy-a-nationwide-survey-of-tertiary-care-delivery-wards
#2
Barbara Perrone, Stefano Ghirardello
Objective Delayed umbilical cord clamping and cord milking are placental transfusion strategies that produce higher iron stores and better hemodynamic conditions in a newborn. We aimed to evaluate their current practice in tertiary-care delivery wards in Italy. Study Design A multiple-choice questionnaire was e-mailed to all the 101 Italian tertiary-care delivery wards. The comparative analysis between categorical variables was performed by the χ(2) test. Result We obtained an 85% (86/101) response rate...
January 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/27998318/management-of-severe-dengue-hemorrhagic-fever-and-bleeding-complications-in-a-primigravida%C3%A2-patient-a-case-report
#3
Hori Hariyanto, Corry Quando Yahya, Primartanto Wibowo, Oloan E Tampubolon
BACKGROUND: The incidence of dengue hemorrhagic fever is increasing among the adult population living in endemic areas. The disease carries a 0.73% fatality rate for the general population, but what happens when the disease strikes a special subpopulation group, the obstetrics? Perhaps the important question specific to this special subpopulation revolves around the right time and mode of delivery under severe coagulopathy and plasma leakage in conditions of imminent delivery. CASE PRESENTATION: A 24-year-old primigravid Sundanese woman presented to our intensive care unit due to acute pulmonary edema secondary to massive plasma leakage caused by severe dengue...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27984250/a-randomized-controlled-trial-of-music-use-during-epidural-catheter-placement-on-laboring-parturient-anxiety-pain-and-satisfaction
#4
Dan M Drzymalski, Lawrence C Tsen, Arvind Palanisamy, Jie Zhou, Chuan-Chin Huang, Bhavani S Kodali
BACKGROUND: Although music is frequently used to promote a relaxing environment during labor and delivery, the effect of its use during the placement of neuraxial techniques is unknown. Our study sought to determine the effects of music use on laboring parturients during epidural catheter placement, with the hypothesis that music use would result in lower anxiety, lower pain, and greater patient satisfaction. METHODS: We conducted a prospective, randomized, controlled trial of laboring parturients undergoing epidural catheter placement with or without music...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27931546/maternal-and-fetal-outcomes-in-pregnant-women-undergoing-balloon-mitral-valvotomy-for-rheumatic-mitral-stenosis
#5
Desabandhu Vinayakumar, G V Vinod, Suresh Madhavan, Mangalath Narayanan Krishnan
BACKGROUND: Rheumatic mitral stenosis constitutes a major cause of acquired heart disease complicating pregnancy in India. In the present study, we have studied the fetal and maternal outcomes of women undergoing balloon mitral valvotomy during pregnancy. METHODS AND RESULTS: 49 pregnant ladies were included in this study in whom balloon mitral valvotomy was performed. The mean age of these patients was 25.7±3.1 years. The mean gestational age was 23.5±5.2 weeks (12-36 weeks)...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27803982/magnesium-in-obstetric-anesthesia-and-intensive-care
#6
REVIEW
Marija S Kutlesic, Ranko M Kutlesic, Tatjana Mostic-Ilic
Magnesium, one of the essential elements in the human body, has numerous favorable effects that offer a variety of possibilities for its use in obstetric anesthesia and intensive care. Administered as a single intravenous bolus dose or a bolus followed by continuous infusion during surgery, magnesium attenuates stress response to endotracheal intubation, and reduces intraoperative anesthetic and postoperative analgesic requirements, while at the same time preserving favorable hemodynamics. Applied as part of an intrathecal or epidural anesthetic mixture, magnesium prolongs the duration of anesthesia and diminishes total postoperative analgesic consumption with no adverse maternal or neonatal effects...
November 1, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27681656/reduced-fetal-brain-fissures-depth-in-fetuses-with-congenital-heart-diseases
#7
Qinghai Peng, Qichang Zhou, Ming Zang, Jiawei Zhou, Ran Xu, Tao Wang, Shi Zeng
OBJECTIVE: To screen and detect cortex gyration in fetuses with congenital heart disease (CHD) using Ultrasonography (US) during routine obstetric scans. METHODS: The depth of the Sylvian fissure (SF), parieto-occipital fissure (POF), and calcarine (CF) fissure were prospectively serially measured and compared in 45 fetuses with CHD and 45 normal fetuses. Cardiac hemodynamic parameters, including aortic valve diameter (AV), pulmonary valve diameter (PV), velocity time integral of the aortic valve (VTIav), and velocity time integral of the pulmonary valve (VTIpv), were recorded...
November 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27651584/use-of-condom-tamponade-to-manage-massive-obstetric-hemorrhage-at-a-tertiary-center-in-rajasthan
#8
Rakesh Hasabe, Kumud Gupta, Pallavi Rathode
INTRODUCTION: Conventionally postpartum hemorrhage (PPH) has been defined as blood loss of more than 500 ml following vaginal delivery and 1000 ml following a cesarean section [Pritchard et al. in Am J Obstet Gynecol 84(10):1271-1282, (1962)]. Another definition labels PPH as any blood loss which causes a 10 % drop in hematocrit [Combs et al. in Obstet Gynecol 77:69-76, (1991)] or which threatens the hemodynamic stability of the patient and necessitates blood transfusion [Prendiville et al...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27559484/a-rare-case-of-c2-sensory-blockade-with-preserved-phrenic-nerve-function-in-an-obstetric-patient
#9
John C Coffman, Kasey Fiorini, Meghan Cook, Robert H Small
High neuraxial blockade is a serious complication in obstetric patients and requires prompt recognition and management in order to optimize patient outcomes. In cases of high neuroblockade, patients may present with significant hypotension, dyspnea, agitation, difficulty speaking or inability to speak, or even loss of consciousness. We report the unusual presentation of an obstetric patient that remained hemodynamically stable and had the preserved ability to initiate breaths despite sensory blockade up to C2...
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27555145/association-between-preoperative-maternal-anxiety-and-neonatal-outcomes-a-prospective-observational-study
#10
Tuna Sahin, Ersel Gulec, Meziyet Sarac Ahrazoglu, Sibel Tetiker
STUDY OBJECTIVE: Preoperative anxiety can be associated with poor postoperative clinical outcomes. We aimed to assess whether preoperative maternal anxiety level of obstetric patients scheduled for elective cesarean surgery has an effect on clinical outcome of the newborn. DESIGN: A prospective observational study. SETTING: Operating room. PATIENTS: Sixty pregnant women with American Society of Anesthesiologists physical status 1 and 2 scheduled for elective cesarean surgery were enrolled...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27555124/the-use-of-sugammadex-in-a-pregnant-patient-with-wolff-parkinson-white-syndrome
#11
Turker Sengul, Ayten Saracoglu, Sibel Sener, Olgac Bezen
Wolff-Parkinson-White (WPW) syndrome is a rare pre-excitation syndrome which develops when atrioventricular conduction occurs through a pathologic accessory pathway known as the bundle of Kent instead of atrioventricular node, hence resulting in tachycardia. Patients with WPW syndrome may experience various symptoms arising from mild-to-moderate chest disease, palpitations, hypotension, and severe cardiopulmonary dysfunction. These patients are most often symptomatic because of cardiac arrhythmias. In this case report, we present an uneventful anesthetic management of a pregnant patient with WPW syndrome undergoing cesarean delivery...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27491768/echocardiography-in-pregnancy-part-1
#12
REVIEW
Shuang Liu, Uri Elkayam, Tasneem Z Naqvi
Cardiovascular disease (CVD) remains the leading cause of maternal mortality, and clinical diagnosis of CVD in women during pregnancy is challenging. Pregnant women with known heart disease require careful multidisciplinary management by obstetric and medical teams to assess for maternal and fetal risk. Echocardiography is a safe and effective diagnostic tool indicated in pregnant women with cardiac symptoms or women with known cardiac disease for appropriate selection of women who require close monitoring of cardiac condition and valvular function...
September 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27457397/-use-of-methotrexate-in-the-ectopic-pregnancy-and%C3%A2-pregnancy-of-unknown-location
#13
J Racková, D Driák, H Neumannová, K Hurt, B Sehnal, M Halaška
OBJECTIVE: There are only a few gynaecological departments in the Czech Republic that use medical treatment of the ectopic pregnancy (EP) or persistent pregnancy of unknown location (PUL). We have started using this method in 2008 at our clinic. The aim of this study was to assess the success rate of conservative medical treatment with methotrexate (MTX) in the dose of 1 mg/kg intramuscularly in patients with ectopic pregnancy or persistent pregnancy of unknown location and to compare the results of clinical history, clinical finding and laboratory results in a group of successful and a group of unsuccessful treatment...
April 2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27457394/-current-status-and-recommendations-for-intrapartum-monitoring-of-fetal-heart-rate
#14
A Měchurová, P Velebil, L Hruban, P Janků
UNLABELLED: Monitoring of fetal heart rate is one of the basic components of obstetrical care, in which the cardiotocography remains the gold standard and screening method in early diagnosis of fetal hypoxia, even after introduction of other selective methods of intrauterine monitoring of fetal well-being. The review article is divided into several parts: pathophysiology of fetal oxygenation, fetal heart rate and changes of fetal hemodynamics, and rules for fetal heart rate auscultation...
April 2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27454295/pravastatin-improves-pregnancy-outcomes-in-obstetric-antiphospholipid-syndrome-refractory-to-antithrombotic-therapy
#15
Eleftheria Lefkou, Apostolos Mamopoulos, Themistoklis Dagklis, Christos Vosnakis, David Rousso, Guillermina Girardi
BACKGROUND: Administration of conventional antithrombotic treatment (low-dose aspirin plus low-molecular weight heparin [LDA+LMWH]) for obstetric antiphospholipid syndrome (APS) does not prevent life-threatening placenta insufficiency-associated complications such as preeclampsia (PE) and intrauterine growth restriction (IUGR) in 20% of patients. Statins have been linked to improved pregnancy outcomes in mouse models of PE and APS, possibly due to their protective effects on endothelium...
August 1, 2016: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27400091/the-management-of-intracranial-aneurysms-during-pregnancy-a-systematic-review
#16
Eric Barbarite, Shahrose Hussain, Anna Dellarole, Mohamed Samy Elhammady, Eric Peterson
Hemodynamic changes during pregnancy may favor the formation and rupture of intracranial aneurysms. Despite this risk, guidelines for managing intracranial aneurysms during pregnancy have not been clearly defined. The objective of this review is to describe the treatment options for pregnant women with intracranial aneurysms, and to report the maternal and fetal outcomes associated with different treatment strategies. A search of the literature was conducted using the PubMed database for the period January 1991 through June 2015...
2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27372270/proposed-diagnostic-criteria-for-the-case-definition-of-amniotic-fluid-embolism-in-research-studies
#17
Steven L Clark, Roberto Romero, Gary A Dildy, William M Callaghan, Richard M Smiley, Arthur W Bracey, Gary D Hankins, Mary E D'Alton, Mike Foley, Luis D Pacheco, Rakesh B Vadhera, J Patrick Herlihy, Richard L Berkowitz, Michael A Belfort
Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Our understanding of risk factors, diagnosis, treatment, and prognosis is hampered by a lack of uniform clinical case definition; neither histologic nor laboratory findings have been identified unique to this condition. Amniotic fluid embolism is often overdiagnosed in critically ill peripartum women, particularly when an element of coagulopathy is involved. Previously proposed case definitions for amniotic fluid embolism are nonspecific, and when viewed through the eyes of individuals with experience in critical care obstetrics, would include women with a number of medical conditions much more common than amniotic fluid embolism...
October 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27363399/identification-of-fetal-cardiac-anatomy-and-hemodynamics-a-novel-enhanced-screening-protocol
#18
Ying Zhang, Ai-Lu Cai, Wei-Dong Ren, Ya-Jun Guo, Dong-Yu Zhang, Wei Sun, Yu Wang, Lei Wang, Yue Qin, Li-Ping Huang
BACKGROUND: Prenatal cardiac screening is of great importance as it contributes to appropriate neonatal management and helps parents to make a decision regarding their pregnancy. The aim of our study was to evaluate the efficiency of a newly proposed screening protocol in the detection of fetal congenital heart disease (CHD). METHODS: This was a prospective study. A total of 52 cases of confirmed CHD fetuses and 248 cases of randomly selected normal fetuses were included in the study...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27193989/should-warm-fresh-whole-blood-be-the-first-choice-in-acute-massive-hemorrhage-in-emergency-conditions
#19
Pınar Kendigelen, Zeynep Kamalak, Deniz Abat
Early management of rapid massive hemorrhage requires early administration of blood products and rapid surgical control of bleeding. Professionals in peripheral hospitals with limited resources often work under conditions similar to those in the military. Described in the present report are 3 cases in which warm fresh whole blood (WFWB) was used in patients with massive bleeding who presented to a peripheral hospital that had no blood products suitable for emergency conditions. Described first is the case of a 16-year-old female patient who underwent emergency cesarean section...
March 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27104347/the-effect-of-maternal-antihypertensive-drugs-on-the-cerebral-renal-and-splanchnic-tissue-oxygen-extraction-of-preterm-neonates
#20
Anne E Richter, Trijntje E Schat, Koenraad N J A Van Braeckel, Sicco A Scherjon, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Drugs with antihypertensive action are frequently used in obstetrics for the treatment of preeclampsia (labetalol) and tocolysis (nifedipine) or for neuroprotection (MgSO4), and may affect the hemodynamics of preterm born neonates. OBJECTIVE: The aim of this study was to assess whether maternal antihypertensive drugs affect multisite oxygenation levels of the neonate. METHODS: Eighty preterm neonates of ≤32 weeks of gestational age were monitored using near-infrared spectroscopy...
2016: Neonatology
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