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Obstetrics; hemodynamics

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https://www.readbyqxmd.com/read/28809063/color-and-power-doppler-combined-with-fetal-intelligent-navigation-echocardiography-fine-to-evaluate-the-fetal-heart
#1
L Yeo, R Romero
OBJECTIVE: To evaluate the performance of color and bidirectional power Doppler ultrasound combined with Fetal Intelligent Navigation Echocardiography (FINE) in examining the fetal heart. METHODS: A prospective cohort study was conducted of fetuses in the second and third trimesters with a normal heart or with congenital heart disease (CHD). One or more spatiotemporal image correlation (STIC) volume datasets, combined with color or bidirectional power Doppler (S-flow) imaging, were acquired in the apical four-chamber view...
August 14, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28802997/prophylactic-use-of-an-intra-aortic-balloon-pump-in-a-high-risk-patient-with-peripartum-cardiomyopathy-requiring-cesarean-delivery
#2
R S Samalavicius, L Puodziukaite, I Radaviciute, I Norkiene, K Urbonas, I Misiuriene, V Janusauskas, A Zorinas, K Rucinskas, P Serpytis
The use of intra-aortic balloon counter-pulsation for circulatory support in pregnant women with cardiac failure is limited to several case reports. Few publications have addressed the use of intra-aortic balloon counter-pulsation during delivery. We report a case using prophylactic intra-aortic counter-pulsation during the management of a cesarean delivery in a patient with peripartum cardiomyopathy. A 28-year-old primigravid female at 37weeks of gestation was admitted with signs of worsening heart failure, and transthoracic echocardiography revealed a decreased left ventricular ejection fraction of 25%...
July 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28749853/the-icu-is-becoming-a-main-battlefield-for-severe-maternal-rescue-in-china-an-8-year-single-center-clinical-experience
#3
Liu Yuqi, Guoliang Tan, Shang Chengming, Sun Xuri
OBJECTIVES: To review the characteristics of and to identify the reasons for severe maternal admissions to the ICU. DESIGN: This was an analytical, observational, open, and retrospective study. SETTING: In our ICU. PATIENTS: A total of 487 severe maternal cases were reviewed during the 8-year study period of January 2009 to December 2016. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 487 severe maternal cases (12...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28674684/effect-of-fetal-sex-on-maternal-and-obstetric-outcomes
#4
REVIEW
Mohammed Al-Qaraghouli, Yu Ming Victor Fang
Fetal sex plays an important role in modifying the course and complications related to pregnancy and may also have an impact on maternal health and well-being both during and after pregnancy. The goal of this article is to review and summarize the findings from published research on physiologic and pathologic changes that may be affected by fetal sex and the effect of these changes on the maternal and obstetrical outcomes. This will help create awareness that fetal sex is not just a random chance event but an interactive process between the mother, the placenta, and the fetus...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28663623/comparison-of-epidural-butorphanol-with-neostigmine-and-epidural-sufentanyl-with-neostigmine-for-first-stage-of-labor-analgesia-a-randomized-controlled-trial
#5
Manoj Chaurasia, Ashok Kumar Saxena, Geetanjali T Chilkoti
BACKGROUND: Epidural administration of neostigmine appears to be safe in the obstetric population. Recently, few studies have concluded 10 μg sufentanil to be an effective adjuvant with epidural neostigmine in providing labor analgesia. However, no study has evaluated the analgesic effect of epidural butorphanol with neostigmine for the same. MATERIALS AND METHODS: The parturients were randomly allocated to one of the three study groups - Group A (n = 30) received butorphanol 1 mg and neostigmine 7 μg/kg...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28605821/abnormal-uterine-bleeding
#6
Cristina Laguna Benetti-Pinto, Ana Carolina Japur de Sá Rosa-E-Silva, Daniela Angerame Yela, José Maria Soares Júnior
Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evidence on the treatment of women with abnormal uterine bleeding, both acute and chronic...
July 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28587365/assessment-of-different-loading-doses-of-dexmedetomidine-hydrochloride-in-preventing-adverse-reaction-after-combined-spinal-epidural-anesthesia
#7
Wanwei Jiang, Qinghui Wang, Min Xu, Yu Li, Rui Yang, Xiaoyang Song, Haixia Duan, Pengbo Zhang
We conducted the present study to investigate the effects of the different loading doses of dexmedetomidine hydrochloride in the prevention of adverse reactions after combined spinal-epidural anesthesia. A total of 200 patients that were admitted to the Department of Obstetrics at the Second Affiliated Hospital of Xi'an Jiaotong University hospital and treated with cesarean section through the use of combined spinal-epidural anesthesia from December, 2014 to June, 2016, were randomly divided into 4 groups. The therapeutic regimens of patients were shown as follows: group A was administered an intravenous pump of 10 ml/l physiological saline in surgery until the end of the delivery...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28556269/cervical-varices-an-unusual-source-of-first-trimester-hemorrhage
#8
Joseph R Wax, Angelina Cartin, Christian Litton, Kelley Conroy, Michael G Pinette
Endocervical varices are a rare cause of obstetrical hemorrhage. Usually presenting in the second and third trimesters, bleeding varices often require pregnancy termination or indicated preterm birth via cesarean delivery. Our patient experienced variceal hemorrhage at 12 weeks' gestation in a dichorionic twin pregnancy conceived through in vitro fertilization. A low-lying placenta resolved at 19 weeks followed by variceal regression at 22 weeks' gestation. Endocervical varices causing first-trimester hemorrhage may regress with resolution of a coexisting low placental implantation, permitting planned vaginal delivery, despite progressive hemodynamic changes of pregnancy...
May 29, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28439387/angiographic-embolization-in-the-treatment-of-puerperal-hematoma
#9
Hasene Özçam, Cihangir Uzunçakmak, Nuri Özgür Kılıçkesmez, Besim Haluk Bacanakgil, Burçin Karakuş, İlhan Nahit Mutlu
Puerperal hematoma is one of the life threatening obstetrical emergencies. Surgical ligation of bleeding vessel may not always be possible for the patients who were hemodynamically unstable, hence pelvic arterial angiography may be preferred as the first line treatment modality for these cases. Pelvic arterial angiography and embolization is a safe, tolerable, and minimally invasive treatment modality in the diagnosis and treatment of pelvic hemorrhage. We present a case of puerperal hematoma after a normal spontaneous delivery treated with bilateral iliac arterial embolization...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28426506/applications-of-noninvasive-hemodynamic-monitoring-in-obstetric-management
#10
John T Sullivan
Clinicians managing obstetric patients are dependent on valid hemodynamic measurements to guide care. Heart rate and noninvasive blood pressure guide most current care. New hemodynamic monitors are being used to report research findings and are being investigated by clinicians for their value to supplement standard monitoring. These include arterial pulse contour analysis, Doppler velocimetry, and bioimpedance among others. This chapter serves to present these new devices with a critical review of their advantages and limitations, and most importantly the validity of their measurements...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28412849/maternal-hemodynamic-changes-and-predictors-of-poor-obstetric-outcome-in-women-with-rheumatic-heart-disease-a-five-year-observational-study
#11
Mohamed Rezk, Osama Elkelani, Abdelhamid Shaheen, Awni Gamal, Hassan Badr
OBJECTIVE: to assess prospectively the maternal cardiovascular hemodynamic changes and obstetric outcome in women with rheumatic heart disease (RHD) and to detect predictors of poor outcome. METHODS: This prospective observational study included 204 pregnant patients with RHD who were divided into two groups; successful pregnancy group with living fetus (n = 126) and poor obstetric outcome group with fetal or neonatal loss (n = 78). Hemodynamic changes, maternal and fetal outcome were assessed and recorded...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28375713/comparing-spinal-blockade-effectiveness-and-maternal-hemodynamics-using-25-gauge-and-29-gauge-spinal-needles-with-the-same-volumetric-flow-rate-in-patients-undergoing-caesarean-section
#12
Taner Ciftci, Hayrettin Daskaya, Serdar Efe
Spinal needles with different diameters can be used to prevent side effects in patients undergoing spinal anaesthesia. However, the velocity of local anaesthetic changes through the spinal needle depending on the diameter of it. Local anaesthetic injection velocity has been reported to be associated with the spinal block level. We aimed to compare spinal needles of different diameters with the same local anaesthetic volumetric flow rate in terms of spinal blockade and hemodynamics in obstetric patients. Eighty-four patients received spinal anaesthesia by either a 25G needle or 29G with the same volumetric flow rate...
April 4, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28306583/successful-resuscitation-following-massive-obstetric-hemorrhage-in-a-patient-of-the-jehovah-s-witness-faith-a-case-report
#13
Richard M Hubbard, Jonathan H Waters, Mark H Yazer
Hemorrhage is a leading cause of maternal morbidity and mortality worldwide. It is especially difficult to treat in patients of the Jehovah's Witness faith because they refuse certain blood products. This case report describes the resuscitation of a parturient Jehovah's Witness whose postcesarean delivery course was complicated by massive hemorrhage from unrecognized arterial bleeding in the intensive care unit with significant hemodynamic instability that necessitated an emergency bedside laparotomy. Her hemoglobin nadir was 1...
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28255383/subserosal-hematoma-of-the-sigmoid-colon-after-vaginal-delivery
#14
N Bacalbașa, R E Bohîlțea, M Dumitru, N Turcan, M M Cîrstoiu
Postpartum hemorrhage is an obstetrical emergency that represents the leading cause of maternal mortality. Severe hemorrhagic complications that could appear postpartum are the abdomino-pelvic hematomas, which result from the rupture of the pelvic vessels. We reported a very rare case of puerperal retroperitoneal subserosal hematoma of sigmoid colon following vaginal delivery, which was successfully managed by conservative methods. As far as we know, there are only a few case reports of intramural hematoma of sigmoid colon in literature, having other etiologies than vaginal delivery trauma...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28236342/maternal-cardiac-output-in-early-labour-a-possible-link-with-obstetrics-risks
#15
Herbert Valensise, Grazia Maria Tiralongo, Ilaria Pisani, Daniele Farsetti, Damiano Lo Presti, Giulia Gagliardi, Ripalta Marica Basile, Gian Paolo Novelli, Barbara Vasapollo
OBJECTIVE: to verify if the hemodynamic assessment of "low risk" pregnant women at term can improve the identification of patients with a maternal or foetal-neonatal complication during labour MATERIALS AND METHODS: a prospective observational study was conducted on 77 pregnant women at term with diagnosis of initial labour. We obtained haemodynamic indices using the USCOM(®) system. Patients were followed until the end of labour to check for foetal-neonatal and maternal outcomes. RESULTS: Eleven patients (14...
February 25, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28131117/identification-and-management-of-obstetric-hemorrhage
#16
REVIEW
Emily J Baird
Obstetric hemorrhage remains the leading cause of maternal death and severe morbidity worldwide. Although uterine atony is the most common cause of peripartum bleeding, abnormal placentation, coagulation disorders, and genital tract trauma contribute to adverse maternal outcomes. Given the inability to reliably predict patients at high risk for obstetric hemorrhage, all parturients should be considered susceptible, and extreme vigilance must be exercised in the assessment of blood loss and hemodynamic stability during the peripartum period...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#17
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
#18
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...
June 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
#19
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
#20
RANDOMIZED CONTROLLED TRIAL
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
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