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Obstetric epidural

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https://www.readbyqxmd.com/read/29664053/labor-onset-oxytocin-use-and-epidural-anesthesia-for-vaginal-birth-after-cesarean-section-and-associated-effects-on-maternal-and-neonatal-outcomes-in-a-tertiary-hospital-in-china-a-retrospective-study
#1
Shao-Wen Wu, He Dian, Wei-Yuan Zhang
Background: In the mainland of China, the trial of labor after cesarean section is still a relatively new technique. In this study, we aimed to investigate the effects of labor onset, oxytocin use, and epidural anesthesia on maternal and neonatal outcomes for vaginal birth after cesarean section (VBAC) in a tertiary hospital in China. Methods: This was a retrospective study carried out on 212 VBAC cases between January 2015 and June 2017 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29662280/effects-of-epidural-labour-analgesia-in-mother-and-foetus
#2
Varsha Laxmikant Deshmukh, Shaswatee S Ghosh, Kanan A Yelikar, Shreeniwas N Gadappa
Objective: Aim of study was to determine effect of epidural analgesia on progress of labour and mode of delivery, to find out its complications in labour and puerperium and to evaluate neonatal outcome in terms of APGAR score. Method: The present study was conducted in Department of Obstetrics and Gynaecology at Government Medical College Aurangabad over period of 2 years from June 2014 to June 2016 after taking approval from institutional ethical board. Hundred low-risk primigravidas were included in the study, 50 women received epidural analgesia for relief of labour pain at 3-4 cm and 50 women served as control...
April 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29657082/horner-s-syndrome-following-obstetric-neuraxial-blockade-a-systematic-review-of-the-literature
#3
D J Chambers, K Bhatia
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. Anaesthetic technique, clinical features, anaesthetic management of the Horner's syndrome and time to resolution were assessed...
March 17, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29656689/risk-factors-for-postpartum-urinary-retention-after-vaginal-delivery-at-term-without-epidural-anesthesia
#4
Shunji Suzuki, Erina Kakizaki, Risa Kobayashi, Satomi Teshima
OBJECTIVE: We performed a retrospective case-control study of vaginal delivery at term without epidural anesthesia to identify clinical predictions of postpartum urinary retention (PUR). METHODS: We reviewed the obstetric records of all singleton vaginal deliveries at Japanese Red Cross, Katsushika Maternity Hospital form January 2016 through December 2017. RESULTS: There were 58 women (2.4%) complicated by PUR and 2391 women without PUR. A multivariate analysis revealed nulliparity, instrumental delivery and episiotomy as independent risk factors for PUR (nulliparity: adjusted or 2...
April 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#5
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627812/role-of-maternal-characteristics-and-epidural-analgesia-on-caesarean-section-rate-in-groups-1-and-3-according-to-robson-s-classification-a-cohort-study-in-an-italian-university-hospital-setting
#6
Stefania Triunfo, Sergio Ferrazzani, Gaetano Draisci, Bruno Antonio Zanfini, Giovanni Scambia, Antonio Lanzone
OBJECTIVE: To investigate the role of maternal characteristics and epidural analgesia (EA) on caesarean section (CS) rates in selected groups by using the Robson 10-Group Classification System (RTGCS). DESIGN: Cohort study. SETTING: Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario 'A. Gemelli', Rome, Italy. PATIENTS: A total of 12 098 deliveries in periods I (1998-1999) and II (2010-2011)...
April 7, 2018: BMJ Open
https://www.readbyqxmd.com/read/29587655/impedance-cardiography-as-tool-for-continuous-hemodynamic-monitoring-during-cesarean-section-randomized-prospective-double-blind-study
#7
Alessandro D'Ambrosio, Antonella Cotoia, Renata Beck, Potito Salatto, Lada Zibar, Gilda Cinnella
BACKGROUND: Impedance Cardiography (ICG) is a non-invasive tool for continuous hemodynamic monitoring. Aims of our study were to assess the utility of ICG to evaluate the hemodynamic impact of 6 mg (GL6) vs 8 mg (GL8) levobupivacaine combined with fentanyl in healthy patients undergoing elective cesarean section; secondary, to compare the duration and quality of analgesia and anesthesia. METHODS: Sixty-two women receiving combined spinal-epidural (CSE) for elective cesarean delivery were randomly allocated to GL6 or GL8 groups...
March 27, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29553965/efficacy-of-an-ergonomic-ankle-support-aid-for-squatting-position-in-improving-pushing-skills-and-birth-outcomes-during-the-second-stage-of-labor-a-randomized-controlled-trial
#8
Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee
BACKGROUND: The physical positions that are adopted by women during childbirth significantly impact their childbirth outcomes and experiences. Literature studies have associated using a squatting position with reduced childbirth pain and increased comfort and pushing efficiency. However, the major disadvantage of the squatting position is that women may lack the muscular fitness and stamina necessary to sustain this position for a long period. PURPOSE: The aim of this study was to compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor...
March 16, 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29543614/neuraxial-labor-analgesia-a-focused-narrative-review-of-the-2017-literature
#9
Mitko Kocarev, Fouzia Khalid, Fatima Khatoon, Roshan Fernando
PURPOSE OF REVIEW: Neuraxial labor analgesia remains the most effective and one of the most commonly utilized methods for pain relief during labor. This narrative review article is a summary of the literature published in 2017 on neuraxial analgesia for labor. RECENT FINDINGS: From a total of 41 identified articles, 13 were included in the review. The topics have been structured into three categories: initiation of neuraxial analgesia, maintenance of neuraxial analgesia, and neuraxial analgesia and obstetric outcomes...
March 14, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#10
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
https://www.readbyqxmd.com/read/29502991/neuraxial-block-for-delivery-among-women-with-low-platelet-counts-a-retrospective-analysis
#11
N Levy, O Goren, A Cattan, C F Weiniger, I Matot
BACKGROUND: Laboring women with low platelet counts may be denied neuraxial block due to concerns about causing a spinal-epidural hematoma. AIMS: To assess the anesthetic management, complications and outcome variables of women with low platelet counts, and to expand the existing data regarding the safety of neuraxial blocks in this patient population. METHODS: This is a retrospective analysis of anesthetic and obstetric data from women with platelet counts <100 000/μL, who were admitted to a single referral center during 2011-2014...
January 31, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29501538/impact-of-epidural-analgesia-on-cesarean-and-operative-vaginal-delivery-rates-classified-by-the-ten-groups-classification-system
#12
M Lucovnik, I Blajic, I Verdenik, T Mirkovic, T Stopar Pintaric
BACKGROUND: The Ten Group Classification System (TGCS) allows critical analysis according to the obstetric characteristics of women in labor: singleton or multiple pregnancy, nulliparous, multiparous, or multiparous with a previous cesarean delivery, cephalic, breech presentation or other malpresentation, spontaneous or induced labor, and term or preterm births. Labor outcomes associated with epidural analgesia may be different among the different labor classification groups. The aim of this study was to explore associations between epidural analgesia and cesarean delivery, and epidural analgesia and assisted vaginal delivery, in women classified using the TGCS...
February 28, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29492141/management-of-obstructive-hydrocephalus-in-pregnant-patient
#13
Murat Şakir Ekşi, Ahmet Öğrenci, Osman Ersegun Batçık, Orkun Koban
De novo obstructive hydrocephalus is a rare event during pregnancy. There are only case reports presented in literature. We aimed to discuss the pathophysiological basis and management options with an exemplary case presentation and review of the current literature. A 28-year-old G2P1 patient presented to our clinic with headache, vomiting, and deteriorated vision at the 8th week of gestation. She had no history of central nervous system infection or trauma. A brain magnetic resonance imaging was obtained. There was hydrocephalus due to cerebral aqueduct stenosis (Evan's index of 58%)...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29486974/use-of-epidural-clonidine-for-the-management-of-analgesia-in-the-opioid-addicted-parturient-on-buprenorphine-maintenance-therapy-an-observational-study
#14
M R Hoyt, U Shah, J Cooley, M Temple
OBJECTIVES: Management of labor analgesia and post-cesarean delivery pain is challenging in the patient taking buprenorphine as opioid addiction maintenance therapy. We observed whether substituting clonidine for fentanyl in an epidural solution would provide adequate analgesia for labor and after cesarean delivery. METHODS: We substituted our standard 2 µg/mL fentanyl in 0.0625% bupivacaine epidural solution with 2 µg/mL clonidine in 0.0625% bupivacaine, or 1...
January 31, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29484511/when-fear-of-childbirth-is-pathological-the-fear-continuum
#15
Léa Poggi, Nelly Goutaudier, Natalène Séjourné, Henri Chabrol
OBJECTIVES: Given that prepartum psychiatric symptoms have been reported to be associated with postpartum disorders, focusing on the prepartum period appears of prime importance. The aim of the current study was threefold: (a) to identify the prevalence rates of women suffering from fear of childbirth (FOC) and tokophobia (b) to explore the association between FOC, obstetrical and psychopathological variables and (c) to identify the independent predictors of the intensity of FOC symptoms, FOC and tokophobia...
February 26, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29455380/clinical-features-and-peripartum-outcomes-in-pregnant-women-with-cardiac-disease-a-nationwide-retrospective-cohort-study-in-japan
#16
Toshiaki Isogai, Hiroki Matsui, Hiroyuki Tanaka, Akira Kohyama, Kiyohide Fushimi, Hideo Yasunaga
Although the number of pregnancies in women with cardiac disease is increasing worldwide, there are few data concerning their clinical characteristics and peripartum outcomes. Using the Diagnosis Procedure Combination database between 2008 and 2014 in Japan, we retrospectively identified pregnant women who underwent high-risk delivery due to obstetric or non-obstetric comorbidities. We classified eligible women into those with pre-existing cardiac disease (cardiac disease group) and those with non-cardiac comorbidities (non-cardiac disease group) and compared their characteristics and peripartum outcomes...
February 17, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29447730/no-163-gynaecological-and-obstetric-management-of-women-with-inherited-bleeding-disorders
#17
Christine Demers, Christine Derzko, Michele David, Joanne Douglas
OBJECTIVE: The prevalence of bleeding disorders, notably von Willebrand disease (vWD), among adult women with objectively documented menorrhagia is consistently reported to be 10% to 20% and is even higher in adolescents presenting with menorrhagia. OPTIONS: Diagnostic tools and specific medical and, where appropriate, surgical alternatives to management are reviewed and evidence-based recommendations presented. EVIDENCE: A MEDLINE search of the English literature between January 1975 and November 2003 was performed using the following key words: menorrhagia, uterine bleeding, pregnancy, von Willebrand, congenital bleeding disorder, desmopressin/DDAVP, tranexamic acid, oral contraceptives, medroxyprogesterone, therapy, hysterectomy, anesthesia, epidural, spinal...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29402441/-ropivacaine-use-in-transnasal-sphenopalatine-ganglion-block-for-post-dural-puncture-headache-in-obstetric-patients-case-series
#18
Inês Furtado, Isabel Flor de Lima, Sérgio Pedro
PURPOSE: Sphenopalatine ganglion block is widely accepted in chronic pain; however it has been underestimated in post dural puncture headache treatment. The ganglion block does not restore normal cerebrospinal fluid dynamics but effectively reduces symptoms associated with resultant hypotension. When correctly applied it may avoid performance of epidural blood patch. The transnasal approach is a simple and minimally invasive technique. In the cases presented, we attempted to perform and report the ganglion block effectiveness and duration, using ropivacaine...
February 2, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29372092/intravenous-remifentanil-analgaesia-for-an-obstetric-patient-with-type-i-neurofibromatosis-and-a-factor-v-leiden-mutation
#19
José L Gálvez, Carlos L Errando, Silvia Serrano, Marga Martín-Ayuso, José M Valverde-Mantecón
Type I neurofibromatosis is characterised by altered skin pigmentation and the growth of benign tumours, particularly along the peripheral nerves and central nervous system. We report a 36-year-old primigravida woman in labour who was admitted to the obstetric suite of the Hospital Sant Joan de Déu, Barcelona, Spain, in 2007 with hypothyroidism, type I neurofibromatosis and a factor V Leiden mutation. Due to a lack of cranial and spinal imaging data, an epidural was not indicated; instead, continuous intravenous remifentanil analgaesia was administered...
November 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29343042/harlequin-syndrome-as-a-rare-complication-after-epidural-anaesthesia-in-an-obstetric-patient
#20
Juan M Redondo, María Rivas, María L Martín, María D Torrado, María J Rodríguez
No abstract text is available yet for this article.
January 17, 2018: Minerva Anestesiologica
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