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Obstetric anesthesia

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https://www.readbyqxmd.com/read/29474277/j-marion-sims-and-the-vesicovaginal-fistula-historical-understanding-medical-ethics-and-modern-political-sensibilities
#1
L Lewis Wall
OBJECTIVES: To review the historical background surrounding the early work of Dr. J. Marion Sims, who developed the first consistently successful surgical technique for the repair of obstetric vesicovaginal fistulas by operating on a group of young, enslaved, African American women who had this condition between 1846 and 1849. METHODS: Review of primary source documents on Sims and his operations, early 19th century clinical literature on the treatment of vesicovaginal fistula, the introduction of ether and chloroform anesthesia into surgical practice, and the literature on the early 19th century medical ethics pertaining to surgical innovation...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29447730/no-163-gynaecological-and-obstetric-management-of-women-with-inherited-bleeding-disorders
#2
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/29427974/time-of-day-is-not-associated-with-increased-rates-of-mortality-in-emergency-surgery-an-analysis-of-49-196-surgical-procedures
#3
Rodney A Gabriel, Alison M A'Court, Ulrich H Schmidt, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: There is a lack of large, multi-institutional studies analyzing the association of timing of emergency surgery with death occurring either intraoperatively or in the recovery room setting. The primary objective of this study was to determine if time of day for emergency surgeries was associated with mortality. DESIGN: Retrospective analysis. SETTING: U.S. healthcare facilities. PATIENTS: Adult patients undergoing emergency surgery and general anesthesia...
February 7, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29416461/does-neck-circumference-help-to-predict-difficult-intubation-in-obstetric-patients-a-prospective-observational-study
#4
Waleed Riad, Tarek Ansari, Nanda Shetty
Background: Failed intubation in obstetrics remains the most common cause of death directly related to anesthesia. Neck circumference has been shown to be a predictor for difficult intubation in morbidly obese patients. The aim of this study was to determine an optimal cutoff point of neck circumference for prediction of difficult intubation in obstetric patients. Methods: Ninety-four parturients scheduled for cesarean section under general anesthesia were included in the study...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29398754/the-effect-of-prophylactic-infusion-of-combined-ephedrin-and-phenylephrine-on-maternal-hemodynamic-after-spinal-anesthesia-for-cesarean-section-a-randomized-clinical-trial
#5
Simin Atashkhoie, Hojat Pourfathi, Bahman Naghipour, Shahla Meshgi
Several techniques have been proposed to prevent hypotension in obstetric patients. Ephedrine and phenylephrine are individually used to prevent maternal hypotension; however, each has its own drawbacks. Some researchers have reported that the infusion of combined ephedrine and phenylephrine immediately after spinal anesthesia for cesarean delivery reduces the incidence of maternal hypotension. Other studies have indicated that the combination is not superior to the infusion of an individual agent. The present study aimed to evaluate the effect of prophylactic infusion of ephedrine and phenylephrine before the induction of spinal anesthesia for cesarean section on maternal hemodynamic...
January 2018: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29397441/evaluation-of-cesarean-scar-after-single-and-double-layer-hysterotomy-closure-a-prospective-cross-sectional-study
#6
Nur Betül Tekiner, Berna Aslan Çetin, Lale Susan Türkgeldi, Gökçe Yılmaz, İbrahim Polat, Ali Gedikbaşı
BACKGROUND: We aimed to determine if there is a difference in the size of the cesarean scar defect using saline infusion sonography (SIS) performed on the postoperative third month in patients who underwent single- or double-layered unlocked closure of their uterine incision during their first cesarean delivery. METHODS: This study was conducted as a prospective cross-sectional study between February 2015 and January 2016 in patients admitted to the labour ward of the Kanuni Sultan Suleyman Training and Research Hospital who subsequently underwent their first delivery by cesarean section...
February 3, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29395575/age-dependent-trigeminal-and-female-specific-lumbosacral-increase-in-herpes-zoster-distribution-in-the-elderly
#7
Kimiyasu Shiraki, Nozomu Toyama, Atsuko Shiraki, Misako Yajima
BACKGROUND: Varicella-zoster virus causes herpes zoster (HZ) along specific dermatomes, but the effects of age and sex on HZ distribution are unclear. OBJECTIVE: We investigated the age- and sex-dependent distribution characteristics of HZ. METHODS: Patients with HZ were monitored by members of the Miyazaki Dermatologist Society. Questionnaires containing information on age, sex, and dermatome distribution and lesion specimens from 2730 patients were collected, and 2508 PCR-diagnosed cases were analyzed...
January 31, 2018: Journal of Dermatological Science
https://www.readbyqxmd.com/read/29378991/postoperative-analgesia-using-bupivacaine-wound-infiltration-with-intravenous-tramadol-or-dexamethasone-following-obstetric-spinal-anaesthesia
#8
N P Edomwonyi, M O Osazuwa, O I Iribhogbe, S E Esangbedo
CONTEXT: Effective management of postcesarean section (CS) pain is important for the well-being of mother and child; even in limited-resource areas, there are drug options which can be explored to achieve this. AIM: This study aimed to compare the analgesic effects of a combination of bupivacaine wound infiltration with either intravenous (IV) dexamethasone or tramadol after CS. SETTING AND DESIGN: This study was a randomized, double-blind, comparative study in a tertiary hospital...
December 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29368789/techniques-for-repair-of-obstetric-anal-sphincter-injuries
#9
Melanie R Meister, Joshua I Rosenbloom, Jerry L Lowder, Alison G Cahill
Importance: Obstetric anal sphincter injuries (OASISs) complicate up to 11% of vaginal deliveries; obstetricians must be able to recognize and manage these technically challenging injuries. Objective: The aim of this study was to share our approach for management of these challenging complications of childbirth based on a multidisciplinary collaboration between general obstetrician-gynecologists, maternal fetal medicine specialists, and female pelvic medicine and reconstructive surgeons established at our institution...
January 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29352624/anesthetic-management-of-two-parturients-with-cerebral-palsy-and-prior-selective-dorsal-rhizotomy
#10
C M Aiudi, E E Sharpe, K W Arendt, J J Pasternak, H P Sviggum
Selective dorsal rhizotomy is a surgical spine procedure used to reduce spasticity in patients with upper motor neuron dysfunction caused by conditions such as cerebral palsy. The optimal anesthetic approach for obstetric patients who have undergone a selective dorsal rhizotomy is unknown. The use and efficacy of neuraxial anesthesia in these patients has not been described. We describe the use of neuraxial anesthesia in two patients with prior selective dorsal rhizotomy. Unless contraindicated for other reasons, a neuraxial anesthetic approach appears to be an effective option in patients with a history of a selective dorsal rhizotomy...
December 15, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29352623/effect-of-method-of-anesthesia-on-the-reproductive-and-obstetric-outcomes-of-heterotopic-pregnancies
#11
F Liu, Y F Liu, J Liu, Y Huang, G F Xu, J Cai, Y Chen, Y Q Wu, Y Y Ying, R J Zhang, D Zhang
BACKGROUND: Anesthesia is commonly used for surgical termination of the extrauterine component of heterotopic pregnancy. We sought to evaluate the effects of general and regional anesthesia during salpingectomy on reproductive and obstetric outcomes of heterotopic pregnancies. METHODS: A two-center, retrospective cohort study was conducted, and 49 heterotopic pregnancies were included. Baseline characteristics, reproductive and obstetric outcomes were compared between the general anesthesia and regional anesthesia groups...
December 7, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29325538/influence-of-isoflurane-exposure-in-pregnant-rats-on-the-learning-and-memory-of-offsprings
#12
Wei Huang, Yunxia Dong, Guangyi Zhao, Yuan Wang, Jingjing Jiang, Ping Zhao
BACKGROUND: About 2% of pregnant women receive non-obstetric surgery under general anesthesia each year. During pregnancy, general anesthetics may affect brain development of the fetus. This study aimed to investigate safe dosage range of isoflurane. METHODS: Forty-eight SpragueDawley (SD) pregnant rats were randomly divided into 3 groups and inhaled 1.3% isoflurane (the Iso1 group), 2.0% isoflurane (the Iso2 group) and 50% O2 alone (the control group) for 3 h, respectively...
January 11, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29325324/-obstetric-outcome-in-pregnancy-complained-with-pulmonary-hypertension
#13
C X Zhu, W Xiong, J Yang, H Q Chen, G Niu, Z L Wang
Objective: To identify whether pregnancy outcomes vary by the severity of pulmonary hypertension. Methods: A retrospective study was conducted on 78 cases of pregnancies complained with pulmonary hypertension who delivered in the First Affiliated Hospital, Sun Yat-sen University from 2006 to 2016.The selected cases were divided into three groups according to severity of pulmonary hypertension: mild pulmonary hypertension group (mild PAH group) was defined as a mean pulmonary artery pressure 30-49 mmHg, moderate pulmonary hypertension (moderate PAH group) as mean pulmonary artery pressure 50-69 mmHg and severe pulmonary hypertension (severe PAH group) as mean pulmonary artery pressure 70 mmHg or greater...
December 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29319586/the-role-of-the-anesthesiologist-in-preventing-severe-maternal-morbidity-and-mortality
#14
Emily McQuaid, Lisa R Leffert, Brian T Bateman
Anesthesiologists are responsible for the safe and effective provision of analgesia for labor and anesthesia for cesarean delivery and other obstetric procedures. In addition, obstetric anesthesiologists often have a unique role as the intensivists of the obstetric suite. The anesthesiologist is frequently the clinician with the greatest experience in the acute bedside management of a hemodynamically unstable patient and expertise in life-saving interventions. This review will discuss (1) risks associated with neuraxial and general anesthesia for labor and delivery, and (2) clinical scenarios in which the obstetric anesthesiologist is commonly called upon to function as a "peridelivery intensivist...
January 9, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29316070/incidence-and-risk-factors-of-severe-lacerations-during-forceps-delivery-in-a-single-teaching-hospital-where-simulation-training-is-held-annually
#15
Yasuko Sano, Chihiro Hirai, Shintaro Makino, Xianglan Li, Jun Takeda, Atsuo Itakura, Satoru Takeda
AIM: This study was conducted to evaluate the incidence of severe lacerations during forceps delivery and the risk factors associated with such delivery in a hospital where simulation training is held annually. METHODS: The medical records of 857 women who underwent forceps delivery at term with singleton cephalic presentation from 2010 to 2015 were reviewed. The relationship between clinical characteristics and birth canal trauma was analyzed. Birth canal trauma included third and fourth degree perineal lacerations...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29305249/sonographic-large-fetal-head-circumference-and-risk-of-cesarean-delivery
#16
Michal Lipschuetz, Sarah M Cohen, Ariel Israel, Joel Baron, Shay Porat, Dan V Valsky, Oren Yagel, Doron Kabiri, Yinon Gilboa, Eyal Sivan, Ron Unger, Eyal Schiff, Reli Hershkovitz, Simcha Yagel
BACKGROUND: Persistently high rates of cesarean deliveries are cause for concern for physicians, patients, and health systems. Prelabor assessment might be refined by identifying factors that help predict an individual patient's risk of cesarean delivery. Such factors may contribute to patient safety and satisfaction as well as health system planning and resource allocation. In an earlier study, neonatal head circumference was shown to be more strongly associated with delivery mode and other outcome measures, than neonatal birth weight...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29295798/pneumocephalus-after-epidural-injection
#17
Jerel Chacko, Kelly Levis, Barry Hahn
BACKGROUND: Pneumocephalus, or air in the intracranial space, is most commonly encountered after trauma or surgery. Epidural injections are commonly performed in obstetrics and pain management. Complications are uncommon and include hemorrhage, cerebrospinal fluid leak, and infection. A rare complication is pneumocephalus, described in only a few case reports of epidural anesthesia. CASE REPORT: We describe a 34-year-old woman complaining of a generalized headache 6 days after an unremarkable vaginal delivery that was assisted by an epidural injection...
December 30, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29291413/impact-of-recommended-changes-in-labor-management-for-prevention-of-the-primary-cesarean-delivery
#18
Claire Thuillier, Sophie Roy, Violaine Peyronet, Thibaud Quibel, Aurélie Nlandu, Patrick Rozenberg
BACKGROUND: The dramatic rise in cesarean delivery (CD) rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. OBJECTIVE: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary CD rate safely...
December 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29274831/preoperative-cesarean-section-intravenous-acetaminophen-treatment-for-postoperative-pain-control-a-randomized-double-blinded-placebo-control-trial
#19
Craig V Towers, Sarah Shelton, Jaclyn van Nes, Emily Gregory, Emily Liske, Arion Smalley, Edward Mobley, Barbara Faircloth, Kim B Fortner
BACKGROUND: The United States currently has an opioid use disorder epidemic and research evaluating ways to minimize the use of opioids post-surgery are needed. One of these options is intravenous (IV) acetaminophen. If the use of preoperative IV acetaminophen was found to be effective for cesarean delivery, this would be beneficial for both the mother and breastfeeding neonate. OBJECTIVE: The primary study objective was to see if maternal opioid use was significantly less in the postoperative period for the study group that received 1 gram of IV acetaminophen preoperatively compared with a control group that received placebo...
December 21, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29261548/prospective-observational-study-of-intraoperative-anesthetic-events-in-district-hospitals-in-namibia
#20
Andrew J Ottaway, Leonard Kabongo
BACKGROUND: Access to safe surgery and anesthesia care is grossly inadequate in low- and middle-income countries, with a shortage of anesthesia providers contributing to this crisis. In Namibia, medical officers typically receive no >3 months of informal training in anesthesia. This study sought to determine the prevalence, currently unknown, of intraoperative adverse anesthetic events in this setting. Further, we assessed surgical volume, complications, and mortality outcomes at the district hospital level...
December 19, 2017: Anesthesia and Analgesia
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