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obstetric analgesia

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https://www.readbyqxmd.com/read/28649565/increasing-regional-anesthesia-use-in-a-serbian-teaching-hospital-through-an-international-collaboration
#1
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/28648158/-advanced-labour-pain-relief
#2
Charlotte Krebs Albrechtsen, Kim Ekelund, Ulla Bang
Delivery and labour pain is normally the most painful event in a woman's lifetime. Physical and psychological factors may influence the severity of labour pain, and labour pain relief is an important issue for the obstetric anaesthetist. We describe the current most effective pharmacological techniques used for labour analgesia: systemically with remifentanil and regionally with epidural analgesia.
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28626856/delivery-parameters-neonatal-parameters-and-incidence-of-urinary-incontinence-6-months-postpartum-a-cohort-study
#3
Stian Langeland Wesnes, Yngvild Hannestad, Guri Rortveit
INTRODUCTION: Contradictory results have been reported regarding most delivery parameters as risk factors for urinary incontinence. We investigated the association between incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors. MATERIAL AND METHOD: This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008. This substudy was based on 7561 primiparous women who were continent before and during pregnancy...
June 19, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28625444/nitrous-oxide-for-labor-analgesia-utilization-and-predictors-of-conversion-to-neuraxial-analgesia
#4
Caitlin D Sutton, Alexander J Butwick, Edward T Riley, Brendan Carvalho
STUDY OBJECTIVE: We examined the characteristics of women who choose nitrous oxide for labor analgesia and identified factors that predict conversion from nitrous oxide to labor neuraxial analgesia. DESIGN: Retrospective descriptive study. SETTING: Labor and Delivery Ward. PATIENTS: 146 pregnant women who used nitrous oxide for analgesia during labor and delivery between September 2014 and September 2015. INTERVENTIONS: Chart review only...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625304/any-news-on-the-postdural-puncture-headache-front
#5
REVIEW
Feyce Peralta, Sarah Devroe
Unintentional dural puncture followed by postdural puncture headache is a well-known complication following neuraxial labor analgesia. Risk factors for the development of postdural puncture headache may be related to the patient's history and characteristics, the neuraxial technique, and obstetrical events. The diagnosis of postdural puncture headache is usually made depending on the clinical presentation (orthostatic headache after a neuraxial procedure). Occasionally, neuroimaging and neurological consultation are warranted...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28616828/perinatal-and-maternal-outcomes-at-term-in-low-risk-pregnancies-according-to-nice-criteria-comparison-between-a-tertiary-obstetrical-hospital-and-midwife-attended-units
#6
Tanja Ignatov, Holm Eggemann, Serban Dan Costa, Atanas Ignatov
PURPOSE: The aim of this study was to evaluate the perinatal and maternal outcomes at term at a single tertiary, university hospital in women with low-risk pregnancies. PATIENTS AND METHODS: We performed a retrospective cohort study of women with low-risk pregnancies, who delivered at University Women's Hospital Magdeburg between January 2010 and December 2014. Data were compared with data published by Brocklehurst et al. 2011. RESULTS: Of the 6052 women investigated, 2014 were classified as low risk according to the NICE criteria and were eligible for analysis...
June 14, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28608722/comparative-analysis-of-inpatient-costs-for-obstetrics-and-gynecology-surgery-patients-treated-with-iv-acetaminophen-and-iv-opioids-versus-iv-opioid-only-analgesia-for-postoperative-pain
#7
Ryan N Hansen, An T Pham, Belinda Lovelace, Stela Balaban, George J Wan
BACKGROUND: Recovery from obstetrics and gynecology (OB/GYN) surgery, including hysterectomy and cesarean section delivery, aims to restore function while minimizing hospital length of stay (LOS) and medical expenditures. OBJECTIVE: Our analyses compare OB/GYN surgery patients who received combination intravenous (IV) acetaminophen and IV opioid analgesia with those who received IV opioid-only analgesia and estimate differences in LOS, hospitalization costs, and opioid consumption...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28607343/failed-epidural-for-labour-what-now
#8
Emilia Guasch, Fabrizio Iannuccelli, Nicolas Brogly, Fernando Gilsanz
Labour epidural failure is a challenging situation for the obstetric anaesthetist, especially when associated to high risk of caesarean delivery, obesity, and difficult airway predictors. Labour epidural failure is still not standardly defined, consequently its incidence is uncertain: improving the knowledge of risk factors related to failure will increase epidural block success rate. Prolonged labours, previous history of epidural failure, and repeated topups needed during labour are recognized risk factors for failure...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28600029/racial-and-ethnic-disparities-in-obstetric-anesthesia
#9
Elizabeth M S Lange, Suman Rao, Paloma Toledo
Racial and ethnic disparities are prevalent within healthcare and have persisted despite advances in medicine and public health. Disparities have been described in the use of neuraxial labor analgesia, with minority women being less likely to use neuraxial labor analgesia than non-minority white women. Minority women are also more likely to have a general anesthetic for cesarean delivery than non-minority women. The origins of these disparities are likely multi-factorial, with patient-, provider-, and systems-level contributors...
June 6, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28599396/five-years-experience-in-an-anesthesiology-antenatal-clinic-for-high-risk-patients
#10
Daniel Shatalin, Yaacov Gozal, Sorina Grisaru-Granovsky, Alexander Ioscovich
INTRODUCTION: The aim, of this study is to describe our approach and outcomes in an outpatient anesthesia/analgesia antepartum clinic among ambulatory high-risk obstetric patients. METHODS: This was a retrospective evaluation of the activity of the anesthesiology antenatal clinic from its inception in 2010 until 2016 (a 5-year period). The clinic works in collaboration with the Department of Obstetrics and Gynecology. The catchment area of the study University Affiliated Hospital attends a multiethnic population characterized by high parity...
May 24, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28598915/anesthetic-and-obstetric-management-of-syringomyelia-during-labor-and-delivery-a-case-series-and-systematic-review
#11
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/28588944/onsite-midwife-led-birth-units-ombus-for-care-around-the-time-of-childbirth-a-systematic-review
#12
Qian Long, Emma R Allanson, Jennifer Pontre, Özge Tunçalp, George Justus Hofmeyr, Ahmet Metin Gülmezoglu
INTRODUCTION: To ensure timely access to comprehensive emergency obstetric care in low- and middle-income countries, a number of interventions have been employed. This systematic review assesses the effects of onsite midwife-led birth units (OMBUs) embedded within hospitals which provide comprehensive emergency obstetric and newborn care. METHODS: Both interventional and observational studies that compared OMBUs with standard medical-led obstetric care were eligible for inclusion...
August 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28574159/bladder-spasm-following-urogenital-fistula-repair
#13
Kenneth C Ekwedigwe, Maradona E Isikhuemen, Ileogben Sunday-Adeoye, Emmanuel N Yakubu, Monday O Eliboh
OBJECTIVE: To examine the occurrence of bladder spasms following surgical repair of urogenital fistula. METHODS: The present retrospective study included data from patients who underwent surgical repair of urogenital fistula at the National Obstetric Fistula Centre, Abakaliki, Nigeria, between June 1, 2015, and May 31, 2016. Patients who underwent rectovaginal fistula repair and those who experienced persistent postoperative pain requiring high doses of analgesia were excluded...
June 2, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28547269/effect-of-intermittent-versus-continuous-bladder-catheterization-on-duration-of-the-second-stage-of-labor-among-nulliparous-women-with-an-epidural-a-randomized-controlled-trial
#14
Abeer Suleiman, Sobhiya Mruwat-Rabah, Gali Garmi, Dorit Dagilayske, Tair Zelichover, Raed Salim
INTRODUCTION AND HYPOTHESIS: Catheterization type among women laboring with epidural analgesia who develop bladder retention has been reported to affect labor duration and mode of delivery. We aimed to compare the effect of continuous bladder catheterization (CC) with that of intermittent bladder catheterization (IC) on the duration of the second stage of labor. METHODS: In a randomized trial, term nulliparous women with singleton gestation who requested epidural analgesia and were unable to void spontaneously were eligible and randomized to either CC or IC...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28520654/systematic-review-of-hydrotherapy-research-does-a-warm-bath-in-labor-promote-normal-physiologic-childbirth
#15
Jenna Shaw-Battista
Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices...
May 17, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28499552/puerperal-ventral-epidural-hematoma-after-epidural-labor-analgesia
#16
I Gruzman, I Shelef, A Y Weintraub, A Zlotnik, O Erez
Serious complications in obstetric anesthesia are a rare occurrence. High neuraxial block, respiratory arrest in labor and delivery, and an unrecognized spinal catheter are among the most frequently reported serious complications. A serious complication occurs in approximately 1:3000 obstetric patients. Neuraxial hematoma after obstetric epidural analgesia or anesthesia is extremely rare. We present a case of a puerperal spinal epidural hematoma following epidural labor analgesia. The patient presented with foot drop, which resolved after conservative treatment...
March 31, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28494909/remifentanil-as-an-alternative-to-epidural-analgesia-for-vaginal-delivery-a-meta-analysis-of-randomized-trials
#17
Myeongjong Lee, Fang Zhu, Jessica Moodie, Zhe Zhang, Davy Cheng, Janet Martin
OBJECTIVES: Although epidural analgesia is considered the gold standard for labor pain management, its use may be restricted in some conditions due to clinical contraindications or availability, and suitable alternatives may be required. The objective of this meta-analysis was to determine whether evidence from randomized trials suggests remifentanil PCA (R-PCA) results in significant differences in maternal satisfaction, analgesic efficacy, and safety compared with conventional epidural analgesia (EA)...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28476691/oxytocin-administration-during-spontaneous-labor-guidelines-for-clinical-practice-guidelines-short-text
#18
C Dupont, M Carayol, C Le Ray, C Deneux-Tharaux, D Riethmuller
No abstract text is available yet for this article.
May 2, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28474356/patients-preferences-for-labor-analgesic-counseling-a-qualitative-analysis
#19
Paloma Toledo, Javiera Pumarino, William A Grobman, Cynthia A Wong, Jane L Holl, Romana Hasnain-Wynia
BACKGROUND: The decision to use, or not use, neuraxial labor analgesia is complex, with both maternal and fetal considerations. Fears and concerns about neuraxial analgesia may influence analgesic decision-making. Little is known about patients' preferences for analgesic counseling. Therefore, the objectives of this qualitative study were to evaluate the sources of information used by patients, the timing and content of antepartum counseling about labor analgesia, and patients' preferences for such counseling...
May 5, 2017: Birth
https://www.readbyqxmd.com/read/28452901/effect-of-pain-and-analgesia-on-compensatory-reserve
#20
Carmen Hinojosa-Laborde, Jessie Renee D Fernandez, Gary W Muniz, Corinne D Nawn, Rebecca K Burns, Thuan H Le, Kathy B Porter, John T Hardy, Victor A Convertino
BACKGROUND: The measurement of the body's capacity to compensate for reduced blood volume can be assessed with a compensatory reserve measurement (CRM). The CRM, which is calculated from changes in features of the arterial waveform, represents the integration of compensatory mechanisms during states of low tissue perfusion and oxygenation, such as hemorrhage. This study was designed to test the hypothesis that pain which activates compensatory mechanisms and analgesia that result in reduced blood pressure are associated with lower compensatory reserve...
July 2017: Journal of Trauma and Acute Care Surgery
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