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Tengke Wang, Jiakai Lu, Qiang Li, Yao Chen, Qing Ye, Jie Gao, Dong Yang, Liyun Zhao, Jiapeng Huang, Jinglan Zhang
BACKGROUND: Pulmonary hypertension during pregnancy carries high mortality rate. The relatively long-acting, specific pulmonary vasodilator treprostinil has been used to improve survival in these parturients. Slow uptitration is performed in most cases, and rapid titration has not been reported in the postpartum period. METHODS: We retrospectively reviewed 17 pregnant patients with severe pulmonary arterial hypertension who were treated with intravenous treprostinil in our institution between 2014 and 2016...
October 12, 2018: Anesthesia and Analgesia
Christine M Warrick, Mark D Rollins
Placenta accreta spectrum is becoming more common and is the most frequent indication for peripartum hysterectomy. Management of cesarean delivery in the setting of a morbidly adherent placenta has potential for massive hemorrhage, coagulopathies, and other morbidities. Anesthetic management of placenta accreta spectrum presents many challenges including optimizing surgical conditions, providing a safe and satisfying maternal delivery experience, preparing for massive hemorrhage and transfusion, preventing coagulopathies, and optimizing postoperative pain control...
October 11, 2018: Clinical Obstetrics and Gynecology
Sharon C Reale, Kathryn J Gray, Edward W Boyer, Dominique Y Arce, Michaela K Farber
The anesthetic management of toxic ingestion during pregnancy requires concomitant concerns for both mother and fetus. We describe the management of a parturient at 33 weeks of gestation after a suicide attempt by ingestion of acetaminophen (APAP) and acetylsalicylic acid (ASA). Timing of toxin ingestion must be determined, prompt antidote administration prioritized, and hepatotoxicity-induced hematologic impairment anticipated. Fetal exposure to toxins must also be minimized. The use of point-of-care rotational thromboelastometry in conjunction with standard coagulation testing in such cases facilitates consideration of neuraxial anesthesia and determination of risk for postpartum hemorrhage...
October 11, 2018: A&A practice
Marli Aparecida Rocha de Souza, Marilene Loewen Wall, Andrea Cristina de Morais Chaves Thuler, Ingrid Margareth Voth Lowen, Aida Maris Peres
OBJECTIVE: To describe the use of IRAMUTEQ software in qualitative data analysis. METHOD: A description for using a software program as a tool to support data processing in qualitative research, carried out in 2015. Data collection was done through interviews using a semi-structured script. RESULTS: Twenty-one (21) companions participated in the study. The five classes resulting from data processing by the software allowed for analysis and interpretation of the nursing performance with the parturient as an active participant in the process of labor and delivery, and in the role of companion in this period...
October 4, 2018: Revista da Escola de Enfermagem da U S P
Gian Luigi Gonnella, Marco Scorzoni, Stefano Catarci, Bruno Antonio Zanfini, Gaetano Draisci
No abstract text is available yet for this article.
October 2018: Korean Journal of Anesthesiology
Charles Ampong Adjei, Fidelis Atibila, Felix Apiribu, Frederick Ahordzor, Priscilla Adumoah Attafuah, Michael Ansah-Nyarko, Richard Asamoah, William Menkah
Global evidence suggests that hepatitis B viral (HBV) infection is endemic in Africa and perinatal transmission remains one of the most important modes of HBV transmission in this area. This cross-sectional survey examined the seroprevalence and knowledge of hepatitis B among pregnant women attending antenatal clinic (ANC) in a mission hospital in Ghana. Systematic sampling technique was used to recruit 196 pregnant women. The level of statistical significance was set at 0.05 alpha level. The hepatitis B prevalence estimate (hepatitis B surface antigen) was 10...
October 8, 2018: American Journal of Tropical Medicine and Hygiene
Heather C Nixon, Jillian Stariha, Jason Farrer, Cynthia A Wong, Max Maisels, Paloma Toledo
BACKGROUND: Physician educators must balance the need for resident procedural education with clinical time pressures as well as patient safety and comfort. Alternative educational strategies, including e-learning tools, may be beneficial to orient novice learners to new procedures and speed proficiency. We created an e-learning tool (computer-enhanced visual learning [CEVL] neuraxial) to enhance trainee proficiency in combined spinal-epidural catheter placement in obstetric patients and performed a randomized controlled 2-center trial to test the hypothesis that use of the tool improved the initial procedure performed by the anesthesiology residents...
October 3, 2018: Anesthesia and Analgesia
Archana Narayanappa, Shivkumar Gurulingaswamy, Umesh Prabhakaraiah, Krishna Kempegowda, Nagarajaiah B Hanumantharayappa
Background: The practice of labor analgesia is an essential part of standard obstetric care. There are many guidelines and programs, which have been setup in labor pain management, in the developed country. In India, the practice of labor analgesia is not very popular. The role of labor analgesia providers lies in educating the parturients about the need of labor analgesia and also to develop comprehensive programs and guidelines in providing it. Aim: The aim of our study was to assess knowledge and practice of labour analgesia among anaesthesiologists across India...
July 2018: Anesthesia, Essays and Researches
M Reschke, J M Sweeney, N Wong
We describe a case in which spinal anesthesia was undertaken in a pregnant patient with a space-occupying tumor and significant symptomatology. The collaborative efforts of all medical disciplines involved and the willingness of the neurosurgeon to discuss and help determine the safety of neuraxial anesthesia, culminated in placing an external ventricular drain to help monitor and manage intracranial pressure, so that we could proceed with spinal anesthesia and more easily monitor neurologic status.
September 6, 2018: International Journal of Obstetric Anesthesia
Becca Feldman, Sharon Orbach-Zinger, Maya Leventer-Roberts, Moshe Hoshen, Noa Dagan, Ran Balicer, Leonid A Eidelman
OBJECTIVE: To evaluate whether a woman's age at first birth is associated with cardiovascular risk and metabolic health outcomes (cardiometabolic outcomes) by age 45. METHODS: This is a retrospective, population-based cohort study that uses electronic health record data from the largest health fund in Israel. Women aged 34-39 at baseline (2004-2006) free of chronic diseases were identified as nulliparous at baseline and were followed up to 10 years (through 2016)...
October 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
Simin Atashkhoei, Reyhaneh Abri, Bahman Naghipour, Pouya Hatami Marandi, Mohammad Taher Fazeli Danesh
Background: Despite preventive strategies, hypotension is the most common complication of spinal anesthesia in cesarean section. Objectives: The aim of this study was to assess the effect of glucose-containing crystalloid infusion on maternal hemodynamic status after spinal anesthesia for cesarean section. Methods: In this prospective, randomized, double-blind clinical trial, 80 parturients undergoing elective cesarean section with spinal anesthesia were studied...
August 2018: Anesthesiology and Pain Medicine
Robert D Eden, Mark I Evans, David W Britt, Shara M Evans, Barry S Schifrin
OBJECTIVE: The cardiotocograph (CTG) or electronic fetal monitoring (EFM) was developed to prevent fetal asphyxia and subsequent neurological injury. From a public health perspective, it has failed these objectives while increasing emergency operative deliveries (emergency operative deliveries (EODs) - emergency cesarean delivery or operative vaginal delivery) for newborns, who in retrospect, actually did not require the assistance. EODs increase the risks of complications and stress for patients, families, and medical personnel...
October 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
Zhaoxia Yang, Lanlan Liu, Jinmei Mu, Wenchen Guo, Shunrong Li, Yanyan Jing, Yanyan Liu
This report aims to retrospectively analyze the clinical effect of local pretreatment with dexamethasone (DXMS) on lower back pain after epidural labor analgesia. Patients with epidural labor analgesia treated in People's Hospital of Rizhao from January 2014 to December 2016 were studied. All 368 cases involved were pregnant primipara with full-term single birth. Parturient received injection of DXMS and lidocaine mixture around the epidural puncture point was the observation group (n=188), and parturient received injection of 0...
October 2018: Experimental and Therapeutic Medicine
K Rana, S Jenkins, M Rana
BACKGROUND: There is no clear consensus about how best to prevent post-dural puncture headache (PDPH) following an accidental dural puncture in parturients. Our primary objective was to investigate whether the insertion of an intrathecal catheter following accidental dural puncture reduces the incidence of PDPH and therapeutic epidural blood patch. METHODS: Anaesthetic records from January 2009 to December 2015 were reviewed retrospectively and parturients who had an accidental dural puncture and/or PDPH were identified...
August 17, 2018: International Journal of Obstetric Anesthesia
Pasi Huuskonen, Leea Keski-Nisula, Seppo Heinonen, Sari Voutilainen, Tomi-Pekka Tuomainen, Juha Pekkanen, Jussi Lampi, Soili M Lehto, Hannariikka Haaparanta, Antti-Pekka Elomaa, Raimo Voutilainen, Katri Backman, Hannu Kokki, Kirsti Kumpulainen, Jussi Paananen, Kirsi Vähäkangas, Markku Pasanen
BACKGROUND: A Finnish joint research effort Kuopio Birth Cohort (KuBiCo) seeks to evaluate the effects of genetics, epigenetics and different risk factors (medication, nutrition, lifestyle factors and environmental aspects) during pregnancy on the somatic and psychological health status of the mother and the child. METHODS: KuBiCo will ultimately include information on 10,000 mother-child pairs who have given their informed consent to participate in this cohort...
September 21, 2018: BMC Pregnancy and Childbirth
Sunil T Pandya, Kiran Mangalampally
Pregnancy is a normal physiologic process with the potential for pathologic states. Pregnancy has several unique characteristics including an utero-placental interface, a physiologic stress that can cause pathologic states to develop, and a maternal-foetal interface that can affect two lives simultaneously or in isolation. Critical illness in pregnant women may result from deteriorating preexisting conditions, diseases that are co-incidental to pregnancy, or pregnancy-specific conditions. Successful maternal and neonatal outcomes for parturients admitted to a maternal critical care facility are largely dependent on a multidisciplinary input to medical or surgical condition from critical care physicians, obstetric anaesthesiologists, obstetricians, obstetric physicians, foetal medicine specialists, neonatologists, and concerned specialists...
September 2018: Indian Journal of Anaesthesia
Anjan Trikha, Preet Mohinder Singh
One of the most important causes of maternal mortality is major obstetric haemorrhage. Major haemorrhage can occur in parturients either during the antepartum period, during delivery, or in the postpartum period. Early recognition and a multidisciplinary team approach in the management are the cornerstones of improving the outcome of such cases. The management consists of fluid resuscitation, administration of blood and blood products, conservative measures such as uterine cavity tamponade and sutures, and finally hysterectomy...
September 2018: Indian Journal of Anaesthesia
Minati Choudhury
Parturient with corrected or uncorrected cardiac problem may undergo neuraxial anaesthesia for several reasons and in different trimesters. The altered physiological state in a parturient is further deranged in the presence of a cardiovascular lesion, producing the added risk to the parturient undergoing a neuraxial block. A detailed evaluation, knowledge regarding cardiovascular disease state, more vigilant monitoring, and a team approach can lead to a successful outcome.
September 2018: Indian Journal of Anaesthesia
Frédéric J Mercier, Dan Benhamou
No abstract text is available yet for this article.
October 2018: Anaesthesia, Critical Care & Pain Medicine
Qiang Lu, Chun-Shan Dong, Jun-Ma Yu, Hao Sun, Peng Sun, Xiang Ma, Chun Luo
Visceral pain is common during epidural anesthesia with mini dose local anesthetics in parturients during cesarean section. To reduce or avoid this complication caused by traction on the abdominal viscera, this study aimed to determine the 50% effective dose (ED50) and 95% effective dose (ED95) of epidural sufentanil as an adjuvant combination with local anesthetics for relief visceral pain in parturients with scarred uterus undergoing elective cesarean section.One hundred parturients with scarred uterus undergoing elective cesarean section under epidural anesthesia were enrolled in this randomized, double-blinded, dose-ranging study...
September 2018: Medicine (Baltimore)
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