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M L Meng, E Wang, C Cain, R Landau
We report the case of a normotensive 31-year-old parturient who received combined spinal-epidural analgesia for early labor, and who was then found to have an unexpectedly low platelet count (25 000/μL) with elevated liver enzymes, but without alterations in blood pressure.
November 29, 2018: International Journal of Obstetric Anesthesia
Iwona Czech, Piotr Fuchs, Anna Fuchs, Miłosz Lorek, Dominika Tobolska-Lorek, Agnieszka Drosdzol-Cop, Jerzy Sikora
Background : To evaluate the effectiveness of pharmacological and non-pharmacological pain relief methods and to compare them. Materials and methods : 258 women were included in the study and interviewed using a questionnaire and the visual analogue scale for pain. They were divided into six groups depending on chosen method of labour pain relief: epidural anaesthesia (EA; n = 42), water immersion and water birth (WB; n = 40), nitrous oxide gas for pain control (G; n = 40), transcutaneous electrical nerve stimulation (TENS) ( n = 50), multiple management (MM; n = 42), none (N; n = 44)...
December 9, 2018: International Journal of Environmental Research and Public Health
Amy Tanner Tubay, Kate A Mansalis, Matthew J Simpson, Nicole H Armitage, Gabriel Briscoe, Vicki Potts
Introduction: Group prenatal care models have been in use in the USA for over 20 years and have shown benefits in reducing rates of preterm birth and low birth weight infants in high-risk civilian populations. Group prenatal care has been widely implemented at military treatment facilities, despite a lack of high-quality evidence for improved perinatal outcomes in this population. Materials and methods: In this randomized, controlled trial, 129 patients at a military treatment facility received either traditional one-on-one prenatal care or group prenatal care using the CenteringPregnancy model...
December 7, 2018: Military Medicine
Houman Teymourian, Shayesteh Khorasanizadeh, Padideh Ansar, Leila Nazari, Masih Ebrahimy Dehkordy
Objectives: In this study, we aimed to compare the effects of bupivacaine alone and in combination with dexmedetomidine on postoperative analgesia, neonatal Apgar score, and bispectral index (BIS), which has been shown to correlate with increased sedation and loss of consciousness in women undergoing cesarean section under spinal anesthesia. Methods: A total of 152 term parturient women scheduled to have elective cesarean section with American Society of Anesthesiologist (ASA) physical status I or II were allocated randomly into two groups to receive either bupivacaine plus placebo (BV group) or bupivacaine plus dexmedetomidine (BVD group)...
October 2018: Anesthesiology and Pain Medicine
Sunil T Pandya, Kausalya Chakravarthy, Aparna Vemareddy
Rapid advances and improved networking abilities have led to the widespread adoption of technology in healthcare, especially focused on diagnostics, documentation and evaluation, or mining of data to improve outcomes. Current technology allows for rapid and accurate decision-making in clinical care decisions for individual patients, collation and analysis at different levels for administrative and financial purposes, and the ability to visualise, analyse, and share data in real time for departmental needs. The adoption of technology may help to improve efficiency and efficacy of healthcare services...
November 2018: Indian Journal of Anaesthesia
Lutz Kaufner, A Karekla, A Henkelmann, S Welfle, K von Weizsäcker, L Hellmeyer, C von Heymann
BACKGROUND: Maternal hypotension is a common side effect of spinal anaesthesia for Caesarean section. The combination of colloid coloading and vasopressors was considered our standard for its prevention and treatment. As the safety of hydroxyethyl starch is under debate, we replaced colloid with crystalloid coloading. OBJECTIVE: We hypothesize that the mean blood pressure drop is greater when coloading with crystalloids. DESIGN: Prospective, observational clinical trial...
December 6, 2018: Journal of Anesthesia
Tengteng Li, Nafei Guo, Hui Jiang, Maher Eldadah
BACKGROUND: Breastfeeding self-efficacy has been shown to be a strong predictor of breastfeeding initiation and duration; however, factors associated with breastfeeding self-efficacy in China are unclear. RESEARCH AIMS: The aims were (a) to describe the breastfeeding self-efficacy of parturient women in Shanghai, China and (b) to identify the sociodemographic factors associated with mothers' breastfeeding self-efficacy. METHODS: This is a cross-sectional retrospective descriptive study...
December 5, 2018: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
Mariana Borsa Mallmann, Antonio Fernando Boing, Yaná Tamara Tomasi, Juliana Cristine Dos Anjos, Alexandra Crispim Boing
OBJECTIVE: to analyze evolution as to conducting seven or more prenatal consultations with pregnant women in Brazil, in the period 2000-2015 according to maternal education level and race/skin color of the newborn baby. METHODS: this was a time series study based on Live Births Information System (SINASC) data; relative and absolute inequalities were investigated, adjusted for maternal age and gestational week in which childbirth occurred. RESULTS: we analyzed approximately 48 million births; the proportion of seven or more prenatal consultations increased nationally (from 46...
November 29, 2018: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
Gabriel Levin, Amihai Rottenstreich
We read the study by Pont et al. with great interest. They performed a retrospective population-based record linkage study evaluating the transfusion risk associated with intended vaginal birth after cesarean (VBAC) compared to elective repeat cesarean section (ERCS). While the authors meticulously address this important issue, several important points warrant further clarification. This article is protected by copyright. All rights reserved.
December 4, 2018: Acta Obstetricia et Gynecologica Scandinavica
Andrew H Mgaya, Hussein L Kidanto, Lennarth Nyström, Birgitta Essén
OBJECTIVE: To evaluate the impact of criteria-based audit (CBA) of obstructed labor and fetal distress on cesarean delivery and perinatal outcomes. METHODS: A cross-sectional study was performed at a tertiary referral hospital in Tanzania. Data were collected before and after CBA (January 2013-November 2013 and July 2015-June 2016). Outcomes of fetal distress (baseline CBA, n=248; re-audit, n=251) and obstructed labor (baseline CBA, n=260; re-audit n=250) were assessed using a checklist...
November 30, 2018: International Journal of Gynaecology and Obstetrics
John Song En Lee, Rehena Sultana, Nian Lin Reena Han, Alex Tiong Heng Sia, Ban Leong Sng
BACKGROUND: Epidural catheter re-siting in parturients receiving labour epidural analgesia is distressing to the parturient and places them at increased complications from a repeat procedure. The aim of this study was to develop and validate a clinical risk factor model to predict the incidence of epidural catheter re-siting in labour analgesia. METHODS: The data from parturients that received labour epidural analgesia in our centre during 2014-2015 was used to develop a predictive model for epidural catheter re-siting during labour analgesia...
November 29, 2018: BMC Anesthesiology
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Ependymomas represent 50-60% of all brain and central nervous system tumors. Previous lumbar spine surgery for resection of an ependymoma should not be considered a relative contraindication for the administration of epidural/subarachnoid anesthesia to patients in labor. Case Description: A 34-year-old G1P0, who underwent resection of an L1-L3 intramedullary ependymoma 8 years previously, presented in active labor with residual left leg numbness and tingling...
2018: Surgical Neurology International
Joyce Green Koettker, Odaléa Maria Bruggemann, Paulo Fontoura Freita, Maria Luiza Gonzalez Riesco, Roberta Costa
OBJECTIVE: To describe obstetric practices in planned home births, assisted by qualified professionals in Brazil. METHOD: This is a descriptive study, with data collected in an online bank maintained by 49 professionals from December 2014 to November 2015, in which the target population was women and newborns assisted in home births. Data were analyzed through descriptive statistics. RESULTS: A total of 667 women and 665 newborns were included...
November 23, 2018: Revista da Escola de Enfermagem da U S P
E Kornilov, S Orbach-Zinger, M Hoshen, C F Weiniger, S Fein, S Fireman, S Firman, A Aviram, L A Eidelman
BACKGROUND: Spinal hypotension causes decreased regional cerebral oxygen saturation (ScO2 ) in women undergoing cesarean delivery. In this study we aimed to measure the change in ScO2 using near infrared spectroscopy in women receiving a prophylactic phenylephrine infusion during cesarean delivery under spinal anesthesia. METHODS: This was a prospective, observational cohort study. Fifty-three women had ScO2 measurements at the following time points: preoperatively, in the supine position with 30° of left lateral tilt; one and five minutes after spinal anesthesia; at the time of skin incision; immediately after delivery; one minute after commencing the oxytocin infusion; at completion of surgery, and one hour after surgery...
September 21, 2018: International Journal of Obstetric Anesthesia
Nicole D Hilber, Koen Rijs, Markus Klimek, Guillermo Saenz, Abdelkarim Aloweidi, Rolf Rossaint, Michael Heesen
INTRODUCTION: Epidural failure due to misidentification of the epidural space is not uncommon. Epidural wave form analysis has been suggested to identify the epidural space. EVIDENCE ACQUISITION: A systematic literature search (Medline, Epub, (Embase plus Medline), Cochrane Central, Web of Science, and Google Scholar) was performed to identify studies comparing epidural wave form analysis (index test) to epidural analgesia (reference test). EVIDENCE SYNTHESIS: 8 studies (3901 patients) were retrieved that provided data on diagnostic accuracy...
November 22, 2018: Minerva Anestesiologica
V Gunka, P Soltani, G Astrakianakis, M Martinez, A Albert, J Taylor, T Kavanagh
BACKGROUND: ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It is believed that skin must be allowed to dry to prevent nerve damage by seeding ChloraPrep® solution into the neuraxis. We aimed to determine ChloraPrep® drying time in pregnant women before initiation of neuraxial anesthesia. METHODS: In 18 parturients undergoing elective cesarean delivery the skin 'wetness' after standardized ChloraPrep® application was prospectively assessed by blotting the skin with tissue paper and observing for residual orange tint...
November 2, 2018: International Journal of Obstetric Anesthesia
E Morell, F M Peralta, N Higgins, A Suchar, P Fitzgerald, R J McCarthy
BACKGROUND: Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia. METHODS: Healthy nulliparous parturients planning to receive neuraxial labor analgesia after admission to labor, and who had a companion with them at the time of interview, were randomized to having a companion present or not present in the labor and delivery room during neuraxial catheter placement...
October 31, 2018: International Journal of Obstetric Anesthesia
M Heesen, K Rijs, N Hilber, W D Ngan Kee, R Rossaint, C van der Marel, M Klimek
BACKGROUND: Phenylephrine is the preferred vasopressor for the prevention and treatment of spinal anaesthesia-induced hypotension during caesarean section, because studies on low-risk elective patients found it to have a less detrimental effect on umbilical artery pH compared with ephedrine. However, limited data exist from high-risk parturients and parturients with uteroplacental insufficiency. METHODS: We systematically searched for randomised, controlled, double-blinded trials of these two vasopressors in high-risk caesarean sections...
October 19, 2018: International Journal of Obstetric Anesthesia
Mathilde Firmin, Gabriel Carles, Bénédicte Mence, Nikila Madhusudan, Emilie Faurous, Anne Jolivet
INTRODUCTION: Postpartum hemorrhage remains the leading cause of maternal death in France. Parturients in western French Guiana have specific sociodemographic features and a high rate of pathological pregnancies. The objective of this study was to determine the incidence of immediate postpartum hemorrhage (IPPH) in western French Guiana, and to describe the etiologies and risk factors. METHODS: A case control study with incident cases was conducted in the Maternity Department of the Western French Guiana Hospital over a period of one year...
November 23, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Li Ling, Shaoping Ma, Ranran Li
The efficacy for rectal medication of methyl carprost suppository combined with oxytocin in preventing and controlling hemorrhage after cesarean section is observed and analyzed. The 180 parturients who are conducted cesarean section in our hospital are selected as research subjects. All parturients are entitled to the right to know and randomly divided into research group and control group with 90 cases in each group. Among them, the parturients in control group are given oxytocin to prevent and control hemorrhage during the operation, while the research group combines with rectal medication of methyl carprost suppository to prevent and control postoperative hemorrhage base on the ways of control group...
September 2018: Pakistan Journal of Pharmaceutical Sciences
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