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https://www.readbyqxmd.com/read/28630830/bilateral-humerus-and-right-femur-fracture-in-a-newborn-after-cesarean-section-for-breech-presentation-in-a-twin-pregnancy-a-very-rare-case-report
#1
P Rahul, Amit Rakesh Grover, S M Ajoy
INTRODUCTION: The most common fractures during vaginal delivery occur in the clavicle, humerus, and femur. Cesarean section reduces the chances of a child having a birth injury. However, in some difficult extractions, long bone fractures may occur. Cesarean section further reduces the incidence of birth injuries, especially in a breech delivery. Maneuvers employed during cesarean section, energetic traction, improper uterine incisions, and contracted uterus may cause these injuries. In the medical literature, there are few articles highlighting the occurrence of long bone fractures during cesarean section...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#2
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28604467/transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-preoxygenation-before-cesarean-delivery-under-general-anesthesia-a-case-report
#3
Maryse Hengen, Rosalie Willemain, Alain Meyer, Bruno Langer, Girish P Joshi, Pierre Diemunsch
Transnasal humidified rapid-insufflation ventilatory exchange has been shown to improve oxygenation and increase apnea time in difficult airway cases. It may also be beneficial in patients vulnerable to rapid desaturation due to limited pulmonary reserve. We report the use of transnasal humidified rapid-insufflation ventilatory exchange for preoxygenation before a cesarean delivery under general anesthesia in a patient with respiratory distress because of pneumonia and heart failure from severe mitral stenosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28603475/oophoropexy-for-ovarian-torsion-a-new-easier-technique
#4
Tamer A Hosny
BACKGROUND: Oophoropexy for ovarian torsion is easy to be done by many tools either suturing to the lateral pelvic wall, plication of the ovarian ligament or even fixation to the back of the uterus, but it is little bit difficult to do it for pregnant women with less manipulation. OBJECTIVE: We propose that using trocar site closure needle can be easier and faster technique to do this. To assess the feasibility of using the trocar site closure needle to do oophoropexy in ovarian torsion and its possible applicability...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28598915/anesthetic-and-obstetric-management-of-syringomyelia-during-labor-and-delivery-a-case-series-and-systematic-review
#5
Gráinne Patricia Garvey, Vibhangini S Wasade, Kellie E Murphy, Mrinalini Balki
BACKGROUND: Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. METHODS: A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28506945/urinary-fistula-a-continuing-problem-with-changing-trends
#6
Sunesh Kumar, Richa Vatsa, Juhi Bharti, Kallol Kumar Roy, Jai Bhagwan Sharma, Neeta Singh, Jyoti Meena, Seema Singhal
OBJECTIVE: Urinary fistula is a distressing complication after difficult vaginal deliveries, obstetric, and gynecologic surgeries. The present study describes a single center's experience in the management of urinary fistula at a tertiary care hospital. It was performed to analyze the etiology of genitourinary fistula, to assess the outcome after surgical repair, and to determine the changing trends in the etiology and management of urinary fistula. MATERIAL AND METHODS: This retrospective study was conducted over 5 years in the department of obstetrics and gynecology, All India Institute of Medical Sciences, New Delhi...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28504991/tablet-e-logbooks-four-thousand-clinical-cases-and-complications-e-logged-by-14-nondoctor-anesthesia-providers-in-nepal
#7
Shristi Shah, Oliver Ross, Stephen Pickering, Stephen Knoble, Indra Rai
BACKGROUND: To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. METHODS: Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28491174/diagnosis-of-abnormally-invasive-posterior-placentation-the-role-of-mr-imaging
#8
Madison R Kocher, Douglas H Sheafor, Evelyn Bruner, Charles Newman, Julio Fernando Mateus Nino
Abnormally invasive placentation is becoming more common with a recent increase in cesarean sections and maternal age, among other risk factors. Ultrasonography is the first line-imaging, but it can be difficult to diagnose when limiting factors are present. Failure to recognize this serious placental abnormality precludes us from making the appropriate plan for the delivery and consequently can lead to fatal results. In this report, we present a case in which magnetic resonance imaging was used to diagnose posterior placenta increta missed by multiple sonographic examinations in a patient with previous myomectomies, and we also include a review of the literature on this topic...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28487113/a-technique-to-positively-identify-the-vaginal-fornices-during-complicated-postpartum-hysterectomy
#9
Michael A Belfort, Alireza A Shamshirsaz, Karin A Fox
The frequency of cesarean hysterectomy is increasing, predominantly driven by an increased incidence of morbidly adherent placenta associated with previous cesarean delivery with or without placenta previa. Most cases of morbidly adherent placenta are located anteriorly with involvement of the bladder. The lower uterine segment in increta and percreta cases frequently is thinned and deformed, with extensive vascular supply to the bulging placenta. This deformation of the lower segment makes identification of the cervicovaginal interface and vaginal fornices difficult...
May 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28456503/novel-oxytocin-receptor-variants-in-laboring-women-requiring-high-doses-of-oxytocin
#10
Erin L Reinl, Zane A Goodwin, Nandini Raghuraman, Grace Y Lee, Erin Y Jo, Beakal M Gezahegn, Meghan K Pillai, Alison G Cahill, Cristina De Guzman Strong, Sarah K England
BACKGROUND: Although oxytocin commonly is used to augment or induce labor, it is difficult to predict its effectiveness because oxytocin dose requirements vary significantly among women. One possibility is that women requiring high or low doses of oxytocin have variations in the oxytocin receptor gene. OBJECTIVES: To identify oxytocin receptor gene variants in laboring women with low and high oxytocin dosage requirements. STUDY DESIGN: Term, nulliparous women requiring oxytocin doses of ≤4 mU/min (low-dose requiring, n = 83) or ≥20 mU/min (high-dose requiring, n = 104) for labor augmentation or induction provided consent to a postpartum blood draw as a source of genomic DNA...
April 26, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28448397/prophylactic-pentazocine-reduces-the-incidence-of-pruritus-after-cesarean-delivery-under-spinal-anesthesia-with-opioids-a-prospective-randomized-clinical-trial
#11
Masato Hirabayashi, Katsushi Doi, Noritaka Imamachi, Tomomune Kishimoto, Yoji Saito
BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28448320/difficult-airway-management-resulting-from-local-anesthetic-allergy-during-emergent-cesarean-delivery-a-case-report
#12
Courtney L Maxey-Jones, Alec Palmerton, Jocelyn R Farmer, Brian T Bateman
Difficult airway management in the gravid patient is a well-described phenomenon. We present a case of emergent cesarean delivery complicated by a "cannot intubate, cannot ventilate" scenario that was later determined to be secondary to an allergic, IgE-mediated reaction to epidurally administered local anesthetic.
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28379868/double-dilemma-management-of-a-pregnant-patient-with-a-difficult-airway-presenting-with-undiagnosed-placenta-percreta-a-case-report
#13
Yewande A Omowanile, Luke N Weiler, Jill M Mhyre, Faiza A Khan
Patients with abnormal placentation should undergo planned cesarean delivery with the option for hysterectomy based on severity. We report a case of a multigravida with a known difficult airway presenting for cesarean delivery. She was found to have an undiagnosed placenta percreta at the start of surgery after the epidural was placed. After team discussion, the procedure was aborted and rescheduled electively 2 days later under general anesthesia with preoperative placement of internal iliac artery balloon catheters...
April 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28331371/vacuum-assisted-cesarean-section
#14
REVIEW
Ross W McQuivey, Jon E Block
There has been a dramatic rise in the frequency of cesarean sections, surpassing 30% of all deliveries in the US. This upsurge, coupled with a decreasing willingness to allow vaginal birth after cesarean section, has resulted in an expansion of the use of vacuum assistance to safely extract the fetal head. By avoiding the use of a delivering hand or forceps blade, the volume being delivered through the uterine incision can be decreased when the vacuum is used properly. Reducing uterine extensions with their associated complications (eg, excessive blood loss) in difficult cases is also a theoretical advantage of vacuum delivery...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28323221/laparoscopic-promontohysteropexy-during-pregnancy
#15
L Pirtea, O Balint, C Secosan, R Ilina, D Grigoras
STUDY OBJECTIVE: to present a case of uterine prolapse in a 10 weeks pregnant patient that was successfully treated by laparoscopic promontohysteropexy. To our knowledge, this is the first case of laparoscopic promontopexy during pregnancy to ever be reported in literature. DESIGN: step by step explanation of the surgery using video SETTING: Uterine prolapse is a rare condition in young patients and extremely are in pregnant women. The incidence of uterine prolapse during pregnancy reported in literature is 1 per 10...
March 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28258945/the-performance-of-neck-circumference-and-other-airway-assessment-tests-for-the-prediction-of-difficult-intubation-in-obese-parturients-undergoing-cesarean-delivery
#16
J Eiamcharoenwit, N Itthisompaiboon, P Limpawattana, A Suwanpratheep, A Siriussawakul
BACKGROUND: Pregnancy and obesity each increase the chance of difficult tracheal intubation. This study assessed the performance of the neck circumference and other bedside tests for predicting difficult intubation, and aimed to identify the optimal cutoff point of the test(s) with the highest performance. METHODS: Parturients with a body mass index ≥30kg/m(2), undergoing a cesarean delivery employing conventional tracheal intubation, were enrolled. Preoperative neck circumference, sternomental distance and modified Mallampati test were examined...
February 5, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28246593/the-performance-of-the-intubation-difficulty-scale-among-obese-parturients-undergoing-cesarean-section
#17
Jatuporn Eiamcharoenwit, Napon Itthisompaiboon, Panita Limpawattana, Arunotai Siriussawakul
Background. There have not yet been any studies to validate the intubation difficulty scale (IDS) in obese parturients. Objectives of this study were to determine the performance of the IDS in defining difficult intubation (DI) and to identify the optimal cutoff points of the IDS among obese parturients. Methods. This was a prospective observational study. Parturients with a body mass index ≥ 30 kg/m(2) who underwent cesarean section utilizing endotracheal intubation were enrolled. The intubating performers were asked to assess the difficulty of endotracheal intubation and categorize it as easy, somewhat DI, and DI...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28235536/the-use-of-ultrasound-in-planned-cesarean-delivery-under-spinal-anesthesia-for-patients-having-nonprominent-anatomic-landmarks
#18
Mursel Ekinci, Hacı Ahmet Alici, Ali Ahiskalioglu, Ilker Ince, Mehmet Aksoy, Erkan Cem Celik, Aysenur Dostbil, Mine Celik, Pinar Karaca Baysal, Birzat Emre Golboyu, Ayşe Nur Yeksan
STUDY OBJECTIVE: The aim of the study was to compare conventional landmark method with ultrasound-guided spinal anesthesia in cesarean delivery cases where spinous processes and interspinous spaces were not prominent on physical examination. DESIGN: Randomized controlled clinical trial. SETTING: Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: Sixty-four 18- to 45-year-old American Society of Anesthesiologists I-II patients scheduled for cesarean delivery under spinal anesthesia having hardly palpated anatomic landmarks on vertebral column...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28224086/early-robotic-repair-of-vesicouterine-fistula-a-case-report-and-literature-review
#19
Othman J Alamoudi, Mohammed A AlTheneyan, Naif Aldhaam, Maher Moazin
As cesarean sections become a more common mode of delivery, they have become the most likely cause of vesicouterine fistula formation. The associated pathology with repeat cesarean deliveries may make repair of these fistulas difficult. Early robotic-surgery offers a 3-dimensional view of the operative field and allows for intricate movements necessary for complex suturing and dissection. These qualities are advantageous in vesicouterine fistula repair. 42 years old female day 12 post-LSCS in author hospital with history of bladder injury and folly's catheter in place since OR complain of gross hematuria for 8 days...
February 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28222238/thrombolysis-with-intravenous-recombinant-tissue-plasminogen-activator-during-early-postpartum-period-a-review-of-the-literature
#20
REVIEW
Munetoshi Akazawa, Makoto Nishida
Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. We performed a computerized MEDLINE and EMBASE search. We collected data for 13 cases of systemic thrombolytic therapy during the early postpartum period, when limiting the early postpartum period to 48 hours after delivery...
February 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
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