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Obstetrics anesthesia

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https://www.readbyqxmd.com/read/28808585/spinal-cord-injury-during-the-second-trimester-of-pregnancy
#1
Ahmad Zaheer Qureshi, Sami Ullah, Anas Jehad AlSaleh, Rubina' Ullah
INTRODUCTION: Pregnancies in women with spinal cord injury (SCI) are at greater risk of morbidity and mortality. Although pregnancy after SCI is well elaborated in the literature, SCI occurring during pregnancy is rarely reported. Abrupt changes in the body physiology because of SCI and the resulting disability add a risk to maternal and fetal well-being. Not only is the burden of care increased but there is also a higher risk of developing pressure ulcers, urinary tract infections, autonomic instability, intrauterine growth retardation and venous thromboembolism...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28799968/core-temperature-monitoring-in-obstetric-spinal-anesthesia-using-an-ingestible-telemetric-sensor
#2
Leon du Toit, Dominique van Dyk, Ross Hofmeyr, Carl J Lombard, Robert A Dyer
BACKGROUND: Perioperative hypothermia may affect maternal and neonatal outcomes after obstetric spinal anesthesia. Core temperature is often poorly monitored during spinal anesthesia, due to the lack of an accurate noninvasive core temperature monitor. The aim of this study was to describe core temperature changes and temperature recovery during spinal anesthesia for elective cesarean delivery. We expected that obstetric spinal anesthesia would be associated with a clinically relevant thermoregulatory insult (core temperature decrease >1...
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28797517/gynecologic-anatomic-abnormalities-following-anorectal-malformations-repair
#3
Alejandra Vilanova-Sanchez, Carlos A Reck, Kate A McCracken, Victoria A Lane, Alessandra C Gasior, Richard J Wood, Marc A Levitt, Geri D Hewitt
BACKGROUND/AIM: Patients may present with gynecologic concerns after previous posterior sagittal anorectoplasty (PSARP) for repair of an anorectal malformation (ARM). Common findings include an inadequate or shortened perineal body, as well as introital stenosis, retained vaginal septum, and remnant rectovestibular fistula. An inadequate or shortened perineal body may impact fecal continence, sexual function and recommendations regarding obstetrical mode of delivery. We describe our experience with female patients referred to our center for evaluation of their previously repaired ARM, with a specific focus on perineal body anatomy and concomitant gynecologic abnormalities...
July 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28795335/encouraging-mindfulness-in-medical-house-staff-via-smartphone-app-a-pilot-study
#4
Louise Wen, Timothy E Sweeney, Lindsay Welton, Mickey Trockel, Laurence Katznelson
BACKGROUND: Stress and burnout are increasingly recognized as urgent issues among resident physicians, especially given the concerning implications of burnout on physician well-being and patient care outcomes. OBJECTIVE: The authors assessed how a mindfulness and meditation practice among residents, supported via a self-guided, smartphone-based mindfulness app, affects wellness as measured by prevalidated surveys. METHODS: Residents in the departments of general surgery, anesthesia, and obstetrics and gynecology were recruited for participation in this survey-based, four-week, single-arm study...
August 9, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28745706/-the-combination-of-endoscopic-techniques-in-the-diagnosis-and-treatment-of-various-forms-of-infertility-in-women
#5
N N Akhundova
AIM: To improve the methods of simultaneous laparoscopy and hysteroscopy for the diagnosis and treatment of various forms of secondary infertility. MATERIAL AND METHODS: 420 women with various forms of infertility were examined and treated at the Caspian Hospital (Institute of Obstetrics and Gynecology). Patients were divided into three groups: tubal-peritoneal infertility - 212 women, different forms of endometriosis - 113 patients, polycystic ovarian disease - 95 women...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28744777/-recent-standards-in-management-of-obstetric-anesthesia
#6
REVIEW
Maximiliaan van Erp, Clemens Ortner, Stefan Jochberger, Klaus Ulrich Klein
The following article contains information not only for the clinical working anaesthesiologist, but also for other specialists involved in obstetric affairs. Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus...
July 25, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#7
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
July 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28730256/advanced-metastatic-breast-cancer-in-pregnancy-the-imperative-of-physical-breast-examination-in-pregnancy
#8
Anca Angela Simionescu, Claudia Valentina Georgescu, Mirela Corina Ghiluşi, Sabrina Ioana Stoica, Mircea Dragoş Median
Breast cancer is the most frequent cancer diagnosed among women; its association with pregnancy is not encountered. As childbearing age is increasing, the diagnosis of breast cancer associated pregnancy tends to be more often than years ago. Here we report a case of a 37-year-old patient, gravida 7, para 7, diagnosed at 30 weeks gestation with metastatic breast cancer. The patient presented to hospital due to an altered performance status. Obstetrical evaluation was within normal range. A metastatic infiltrating breast cancer poorly differentiated (G3) with satellite skin lesions (T4b), ipsilateral axillary and supraclavicular lymph nodes (N3), lung metastasis bilateral with pleural effusion and hepatic metastasis (M1), were diagnosed...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#9
Gordon Yuill, Ashot Amroyan, Simon Millar, Emil Vardapetyan, Ashraf S Habib, Medge D Owen
BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28708666/socioeconomic-deprivation-and-utilization-of-anesthetic-care-during-pregnancy-and-delivery-a-french-retrospective-multicenter-cohort-study
#10
Elie Kantor, Jean Guglielminotti, Elie Azria, Dominique Luton, Mandelbrot Laurent, Jean-François Oury, Dominique Mahieu-Caputo, Philippe Ravaud, Candice Estellat
BACKGROUND: Socioeconomic deprivation is associated with reduced use of antenatal resources and poor maternal outcomes with pregnancy. Research examining the association between socioeconomic deprivation and use of obstetric anesthesia care in a country providing universal health coverage is scarce. We hypothesized that in a country providing universal health coverage, France, socioeconomic deprivation is not associated with reduced use of anesthetic care during pregnancy and delivery...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#11
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
March 18, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28682955/ringer-s-lactate-versus-normal-saline-in-urgent-cesarean-delivery-in-a-resource-limited-setting-a-pragmatic-clinical-trial
#12
Emmanuel Timarwa Ayebale, Arthur Kwizera, Cephas Mijumbi, Samuel Kizito, Anthony Michael Roche
BACKGROUND: Crystalloids are used routinely for perioperative fluid management in cesarean delivery. Few studies have determined the crystalloid of choice in obstetric anesthesia. We compared the effects of Ringer's lactate (RL) versus 0.9% normal saline (NS) on maternal and neonatal blood pH and 24-hour postoperative morbidity in urgent cesarean delivery in a low-resource setting. Our hypothesis was that RL would result in 30% less acidosis than NS. METHODS: This was a pragmatic prospective double-blind randomized controlled trial in the Mulago National Referral Hospital Labor Ward Theater from September 2011 to May 2012...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28678882/insertion-of-an-intrathecal-catheter-in-parturients-reduces-the-risk-of-post-dural-puncture-headache-a-retrospective-study-and-meta-analysis
#13
Jiali Deng, Lizhong Wang, Yinfa Zhang, Xiangyang Chang, Xingjie Ma
This study aimed to determine whether insertion of an intrathecal catheter following accidental dural puncture (ADP) in obstetric patients can reduce the incidence of post-dural puncture headache (PDPH) and the requirement of a therapeutic epidural blood patch (TEBP). This was also compared with relocating the epidural catheter at a different vertebral interspace. A retrospective study was performed, as well as a meta-analysis of the literature to further validate our findings. We reviewed the records of 86 obstetric patients who suffered from ADP during epidural anesthesia or combined spinal-epidural anesthesia from October 2015 to November 2016 at our institution...
2017: PloS One
https://www.readbyqxmd.com/read/28678073/prophylactic-norepinephrine-infusion-for-preventing-hypotension-during-spinal-anesthesia-for-cesarean-delivery
#14
Warwick D Ngan Kee, Shara W Y Lee, Floria F Ng, Kim S Khaw
BACKGROUND: The use of norepinephrine for maintaining blood pressure (BP) during spinal anesthesia for cesarean delivery has been described recently. However, its administration by titrated manually controlled infusion in this context has not been evaluated. METHODS: In a double-blinded, randomized controlled trial, 110 healthy women having spinal anesthesia for elective cesarean delivery were randomly allocated to 1 of 2 groups. In group 1, patients received an infusion of 5 μg/mL norepinephrine that was started at 30 mL/h (2...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28663641/the-postdural-puncture-headache-and-back-pain-the-comparison-of-26-gauge-atraucan-and-26-gauge-quincke-spinal-needles-in-obstetric-patients
#15
Mehmet Salim Akdemir, Ayhan Kaydu, Yonca Yanlı, Mehtap Özdemir, Erhan Gökçek, Haktan Karaman
BACKGROUND: The postdural puncture headache (PDPH) and postdural puncture backache (PDPB) are well-known complications of spinal anesthesia. There are some attempts to reduce the frequency of complication such as different design of the spinal needles. AIMS: The primary outcome of this study is to compare the incidence of PDPH between 26-gauge Atraucan and 26-gauge Quincke spinal needles in elective cesarean operations. The severity of symptoms, the incidence of backache, technical issues, and comparison of cost of needles are secondary outcomes...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28653359/ultrasound-assessment-of-gastric-content-in-the-immediate-postpartum-period-a-prospective-observational-descriptive-study
#16
F Vial, N Hime, J Feugeas, N Thilly, P Guerci, H Bouaziz
INTRODUCTION: Pulmonary aspiration of gastric contents in pregnant women undergoing general anesthesia or sedation/analgesia in the peripartum period is a feared complication in obstetric anesthesia. We assessed the changes in antral cross-sectional area (CSA) with ultrasonography in laboring women and in the immediate postpartum period. PATIENTS AND METHODS: In an observational study in a university-affiliated maternity, gastric ultrasonography examinations were performed in non-consecutive laboring women, after epidural analgesia insertion and after childbirth...
June 26, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28649565/increasing-regional-anesthesia-use-in-a-serbian-teaching-hospital-through-an-international-collaboration
#17
REVIEW
Curtis L Baysinger, Borislava Pujic, Ivan Velickovic, Medge D Owen, Joanna Serafin, Matthew S Shotwell, Ferne Braveman
Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28639240/approach-to-thyroid-carcinoma-in-pregnancy
#18
Cristina Modesti, Paola Aceto, Lucia Masini, Celestino Pio Lombardi, Rocco Bellantone, Liliana Sollazzi
Thyroid carcinoma is the first cancer found in general population and the second diagnosed during pregnancy following the breast one. Diagnostic and therapeutic approaches to thyroid malignancy in pregnant women pose several and serious issues to the physicians. Even if there is no consensus about the surgical treatment of thyroid carcinomas during pregnancy, a large number of women undergo surgery over the world. The best surgical and anesthesiological treatment should be chosen after reaching a consensus between surgeons, anesthesiologists, obstetrics, and the patients...
June 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28632532/postpartum-tubal-sterilization-making-the-case-for-urgency
#19
Michael G Richardson, Sarah J Hall, Lisa C Zuckerwise
The parturient who requests postpartum sterilization has given consideration to and has made decisions regarding this aspect of her medical care long before her delivery. She arrives at parturition expecting the postpartum procedure to be performed as intended. The American Congress of Obstetricians and Gynecologists has reaffirmed its opinion that postpartum sterilization is an urgent procedure, owing to the safety and superior effectiveness of tubal sterilization via minilaparotomy in the immediate postpartum period, and the adverse consequences for mothers, babies, and society when the procedure is not actualized as desired and intended...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28630690/incidence-and-risk-factors-for-surgical-site-infections-in-obstetric-and-gynecological-surgeries-from-a-teaching-hospital-in-rural-india
#20
Ashish Pathak, Kalpana Mahadik, Manmat B Swami, Pulak K Roy, Megha Sharma, Vijay K Mahadik, Cecilia Stålsby Lundborg
BACKGROUND: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. METHODS: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included...
2017: Antimicrobial Resistance and Infection Control
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