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Obstetric anaesthesia emergencies

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https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#1
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29096592/-safe-yet-violent-women-s-experiences-with-obstetric-violence-during-hospital-births-in-rural-northeast-india
#2
Sreeparna Chattopadhyay, Arima Mishra, Suraj Jacob
The majority of maternal health interventions in India focus on increasing institutional deliveries to reduce maternal mortality, typically by incentivising village health workers to register births and making conditional cash transfers to mothers for hospital births. Based on over 15 months of ethnographically informed fieldwork conducted between 2015 and 2017 in rural Assam, the Indian state with the highest recorded rate of maternal deaths, we find that while there has been an expansion in institutional deliveries, the experience of childbirth in government facilities is characterised by obstetric violence...
November 3, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/29044462/urgency-of-caesarean-section-grading-alarm-chain-and-intrauterine-resuscitation-a-survey-of-scandinavian-practice
#3
K Wildgaard, M Ismaiel, F Hetmann
BACKGROUND: About 40,000 women have caesarean section in Scandinavia each year. Organizational factors for emergency caesarean section (CS), classification, anaesthetic practice, alarm chain, intrauterine resuscitation has all been investigated in the United Kingdom, but no information from the Scandinavian countries exists. METHODS: Using publicly available data from the National Board of Health, obstetric anaesthetic departments were identified. The heads of the departments provided e-mail contact details of two anaesthesiologists regularly practicing obstetric anaesthesia who were then surveyed...
October 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28841636/research-ethics-committee-approval-as-reported-for-abstracts-submitted-to-the-annual-euroanaesthesia-meeting
#4
Paul McConnell, Nechama Kaufman, Stefan De Hert, Charles Marc Samama, Zsolt Molnar, Sharon Einav
BACKGROUND: The annual congress of the European Society of Anaesthesiology (ESA) is one of the largest anaesthesia congresses in the world and exhibits more than 1200 abstracts annually. OBJECTIVES: The aims of this study were to quantify the frequency of inadequate evidence of ethical approval for abstracts submitted to the ESA congress and to examine whether abstracts without appropriate ethical approval were subsequently accepted. DESIGN AND SETTING: All abstracts submitted in 2015 were adjudicated according to European ethical criteria...
December 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28764269/analysis-of-clinical-indicators-of-quality-in-patients-with-endotracheal-intubation
#5
Sulochana Dash, Sreelatha Balasubramanian
INTRODUCTION: Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. AIM: This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28728520/in-and-out-hospital-mortality-rate-in-surgical-patients
#6
Philippe Dony, Magali Pirson, Jean G Boogaerts
BACKGROUND: Death rates after surgery are increasingly analysed for clinical audit and quality assessment. Many studies commonly provide information only on deaths that occur during hospital stay, known as in-hospital death rates. By using hospital data set linked to death certificate registry, we recorded in- and out-hospital deaths within 30 and 60 post-operative days. METHODS: The study included all consecutive surgical procedures (denominator) under general or locoregional anaesthesia in adult patients admitted for elective or non-elective inpatient surgery...
July 20, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28711179/immediate-birth-an-analysis-of-women-and-their-babies-undergoing-time-critical-birth-in-a-tertiary-referral-obstetric-hospital
#7
M H Warren, J Kamania, A T Dennis
BACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014...
June 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28622635/management-of-parturients-with-factor-xi-deficiency-10year-case-series-and-review-of-literature
#8
REVIEW
Lynda Verghese, Efterpi Tingi, Jecko Thachil, Charles Hay, Louise Byrd
This is an article reviewing the management of pregnant women with factor XI (FXI) deficiency. Retrospective review of the electronic records of 67 pregnancies in 25 women with FXI deficiency over a ten-year period was undertaken. All women received care at St Mary's Tertiary Referral Obstetric/Haematology Clinic for some or all of their pregnancies. Outcome measures included antenatal complications, mode of delivery, anaesthesia provided and postpartum haemorrhage (PPH) and management required. A positive bleeding history was identified in 50% of women prior to pregnancy...
August 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28403414/a-national-survey-of-videolaryngoscopy-in-the-united-kingdom
#9
T M Cook, F E Kelly
Background.: There are increasing numbers of videolaryngoscopes marketed and increasing interest in the technology. The Difficult Airway Society's 2015 guidelines recommend that videolaryngoscopes should be immediately available at all times and that all anaesthetists should be trained and skilled in their use. Methods.: An electronic survey was sent to all UK National Health Service hospitals to examine availability, use, and attitudes to videolaryngoscopy, and closed in January 2014...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28377839/comparison-of-patient-satisfaction-between-general-and-spinal-anaesthesia-in-emergency-caesarean-deliveries
#10
Arzu Açıkel, Tülün Öztürk, Aslı Göker, Gonca Gül Hayran, Gönül Tezcan Keleş
OBJECTIVE: Obstetric anaesthesia aims to deliver a healthy baby as well as render a comfortable operation for the mother. This study compared general and spinal anaesthesia in terms of the quality of recovery and patient satisfaction in women undergoing emergency caesarean deliveries. METHODS: In total, 100 patients were enrolled in this prospective, single-blind, cross-sectional clinical study. Patients were divided into spinal (n=50) and general (n=50) anaesthesia groups...
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#11
Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28275833/survey-of-emergency-and-essential-surgical-obstetric-and-anaesthetic-services-available-in-bangladeshi-government-health-facilities
#12
Jonathan Loveday, Sonal P Sachdev, Meena N Cherian, Francisco Katayama, A K M Akhtaruzzaman, Joe Thomas, N Huda, E Brian Faragher, Walter D Johnson
OBJECTIVE: Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. METHODS: Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies...
July 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#13
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
https://www.readbyqxmd.com/read/28070884/a-national-survey-of-neurological-monitoring-practice-after-obstetric-regional-anaesthesia-in-the-uk
#14
E Roderick, J Hoyle, S M Yentis
Neuraxial anaesthesia is widely used in obstetrics and neurological complications are rare. However, when they occur, subsequent investigation and management are time-critical and correlate with the extent of neurological recovery. The Third National Audit Project recommended the implementation of guidelines in obstetric epidural management, including advice on monitoring for early signs of problems and acting upon concerns. However, no national guideline exists for postoperative management in the obstetric population...
January 10, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#15
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27738833/measuring-the-burden-of-surgical-disease-averted-by-emergency-and-essential-surgical-care-in-a-district-hospital-in-papua-new-guinea
#16
Matthew A R Stokes, Glenn D Guest, Perista Mamadi, Westin Seta, Noel Yaubihi, Grace Karawiga, Billy Naidi, David A K Watters
BACKGROUND: Timely access to emergency and essential surgical care (EESC) and anaesthesia in low- and middle-income countries (LMICs) prevents premature death, minimises lifelong disability and reduces their economic impact on families and communities. Papua New Guinea is one of the poorest countries in the Pacific region, and provides much of its surgical care at a district hospital level. We aimed to evaluate the surgical capacity of a district hospital in PNG and estimate the effectiveness of surgical interventions provided...
March 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27651627/role-of-thromboelastography-versus-coagulation-screen-as-a-safety-predictor-in-pre-eclampsia-eclampsia-patients-undergoing-lower-segment-caesarean-section-in-regional-anaesthesia
#17
Asrar Ahmad, Monica Kohli, Anita Malik, Megha Kohli, Jaishri Bogra, Haider Abbas, Rajni Gupta, B B Kushwaha
PURPOSE: In this study, we aimed to correlate thromboelastography (TEG) variables versus conventional coagulation profile in all patients presenting with pre-eclampsia/eclampsia and to see whether TEG would be helpful for evaluating coagulation in parturients before regional anaesthesia. MATERIALS AND METHODS: This was a prospective study on 100 pre-eclampsia/eclampsia patients undergoing lower-segment caesarean section under regional anaesthesia. Two blood samples were collected...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27443946/increasing-the-availability-and-quality-of-caesarean-section-in-tanzania
#18
A Nyamtema, N Mwakatundu, S Dominico, H Mohamed, A Shayo, R Rumanyika, C Kairuki, C Nzabuhakwa, O Issa, C Lyimo, I Kasiga, J van Roosmalen
OBJECTIVE: To describe the results of increasing availability and quality of caesarean deliveries and anaesthesia in rural Tanzania. DESIGN: Before-after intervention study design. SETTINGS: Rural Tanzania. METHODS: Ten health centres located in rural areas were upgraded to provide comprehensive emergency obstetric care (CEmOC) and the four related district hospitals were supported. Upgrading entailed constructing and equipping maternity blocks, operation rooms and laboratories; installing solar systems, backup generators and water supply systems...
September 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27259094/determination-of-a-cut-off-value-of-antral-area-measured-in-the-supine-position-for-the-fast-diagnosis-of-an-empty-stomach-in-the-parturient-a-prospective-cohort-study
#19
Lucille Jay, Laurent Zieleskiewicz, François-Pierrick Desgranges, Bérengère Cogniat, Marius Pop, Pierre Boucher, Amandine Bellon, Marc Léone, Dominique Chassard, Lionel Bouvet
BACKGROUND: Ultrasound measurement of the antral cross-sectional area of the stomach, performed in the supine position, has been described for preoperative assessment of gastric content in the adult, but, to date, no study has determined the cut-off value of the antral area for the diagnosis of an empty stomach in the parturient. Nevertheless, previous studies in parturients have reported that the use of a simple qualitative grading scale (0 to 2) was reliable for the estimation of the gastric fluid volume...
March 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/26986725/enhancing-maternal-and-perinatal-health-in-under-served-remote-areas-in-sub-saharan-africa-a-tanzanian-model
#20
MULTICENTER STUDY
Angelo S Nyamtema, Nguke Mwakatundu, Sunday Dominico, Hamed Mohamed, Senga Pemba, Richard Rumanyika, Clementina Kairuki, Irene Kassiga, Allan Shayo, Omary Issa, Calist Nzabuhakwa, Chagi Lyimo, Jos van Roosmalen
BACKGROUND: In Tanzania, maternal mortality ratio (MMR), unmet need for emergency obstetric care and health inequities across the country are in a critical state, particularly in rural areas. This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC) services in underserved rural areas using associate clinicians. METHODS: Ten health centres (HCs) were upgraded by constructing and equipping maternity blocks, operating rooms, laboratories, staff houses and installing solar panels, standby generators and water supply systems...
2016: PloS One
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