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Cesarean blood pressure

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https://www.readbyqxmd.com/read/28331371/vacuum-assisted-cesarean-section
#1
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/28298781/analgesic-efficacy-of-transverse-abdominal-plane-block-after-elective-cesarean-delivery-bupivacaine-with-fentanyl-versus-bupivacaine-alone-a-randomized-double-blind-controlled-clinical-trial
#2
Roshan John, R V Ranjan, T R Ramachandran, Sagiev Koshy George
BACKGROUND: The analgesic benefit of transversus abdominis plane (TAP) blocks for cesarean delivery remains controversial. In our study, we compared the analgesic efficacy of TAP block using local anesthetic bupivacaine and adjunct fentanyl with bupivacaine alone in patients undergoing elective cesarean section. METHODS: Our study was a randomized, double-blind, controlled clinical trial where sixty patients undergoing elective cesarean delivery under subarachanoid block (2 ml of 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28274928/effects-of-childbirth-on-podocyturia-in-women-with-normotensive-uncomplicated-pregnancies
#3
Itsuko Furuta, Tianyue Zhai, Takeshi Umazume, Satoshi Ishikawa, Kinuko Nakagawa, Takashi Kojima, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
Changes in hemodynamics and blood pressure occur shortly before and after childbirth regardless of the mode of delivery. This study aimed to test the hypothesis that parturition induces a temporal increase in podocyturia monitored by podocyte-specific protein podocin mRNA expression levels (Pod-mRNA). A total of 105 urine specimens, consisting of 43 and 62 from 18 and 20 otherwise healthy women with vaginal (VD) and elective cesarean deliveries (ECS), respectively, were studied. Determination of urine protein and creatinine concentrations and quantitative analyses of Pod-mRNA, nephrin mRNA (Nep-mRNA), synaptopodin mRNA (Syn-mRNA), and aquaporin 2 mRNA expression (AQP2-mRNA) were performed using RT-PCR in pelleted urine samples...
March 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28274172/preeclampsia-in-jordan-incidence-risk-factors-and-its-associated-maternal-and-neonatal-outcomes
#4
Yousef S Khader, Anwar Batieha, Rania Ali Al-Njadat, Sa'ad S Hijazi
OBJECTIVES: To estimate the incidence of preeclampsia among Jordanian pregnant women, determine its risk factors and its associated neonatal morbidity and mortality. METHODS: The study is a part of a comprehensive national study of perinatal mortality that was conducted in Jordan. This study included all women who gave birth in the selected hospitals during the study period. Maternal and medical conditions during pregnancy and neonatal outcomes were compared between women who developed preeclampsia and who did not...
March 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28248702/norepinephrine-intermittent-intravenous-boluses-to-prevent-hypotension-during-spinal-anesthesia-for-cesarean-delivery-a-sequential-allocation-dose-finding-study
#5
Desire N Onwochei, Warwick D Ngan Kee, Lillia Fung, Kristi Downey, Xiang Y Ye, Jose C A Carvalho
BACKGROUND: The use of phenylephrine as the first-line agent for prevention and treatment of maternal hypotension during cesarean delivery (CD) may reduce cardiac output, posing a theoretical risk to mother and fetus. Norepinephrine has been suggested as a potential alternative, because its β-adrenergic effects might result in greater heart rate and cardiac output than phenylephrine. The use of norepinephrine to prevent and treat hypotension during CD is new, and its use as a bolus has not been fully determined in this context...
February 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28244952/prophylactic-phenylephrine-infusions-to-reduce-severe-spinal-anesthesia-hypotension-during-cesarean-delivery-in-a-resource-constrained-environment
#6
David G Bishop, Carel Cairns, Mariette Grobbelaar, Reitze N Rodseth
Phenylephrine infusions are considered as standard management for obstetric spinal hypotension, but there remains reluctance to implement them in resource-limited contexts. This prospective, alternating intervention study of patients undergoing elective or urgent cesarean delivery under spinal anesthesia compared a vasopressor bolus strategy to fixed-rate, low-dose prophylactic phenylephrine infusion with supplemental boluses. The primary outcome was the incidence of severe hypotension (mean arterial pressure <70% baseline or systolic blood pressure <80 mm Hg)...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28235526/cardiac-output-changes-with-phenylephrine-and-ephedrine-infusions-during-spinal-anesthesia-for-cesarean-section-a-randomized-double-blind-trial
#7
W Mon, A Stewart, R Fernando, K Ashpole, N El-Wahab, S MacDonald, P Tamilselvan, M Columb, Y M Liu
Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 μg/min or ephedrine 5 mg/min infusions...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28196269/shock-index-and-vital-sign-reference-ranges-during-the-immediate-postpartum-period
#8
Dyese Taylor, Adiel Fleischer, Natalie Meirowitz, Lisa Rosen
OBJECTIVE: To determine reference ranges for patient vital signs during the immediate postpartum period. METHODS: A retrospective chart review collected data on the variables of interest for all women with 0-24-hour postpartum data available at two hospitals in New York, NY, USA, between July 1, 2012, and January 31, 2015. Patients were excluded if they had received antihypertensives, uterotonics, or blood products. Regression lines, with 95% prediction intervals, were constructed for shock index, systolic blood pressure, heart rate, pulse pressure, and rate over pressure evaluation (ROPE) values...
February 14, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28164084/comparison-of-phenylephrine-and-ephedrine-in-treatment-of-spinal-induced-hypotension-in-high-risk-pregnancies-a-narrative-review
#9
REVIEW
Sasima Dusitkasem, Blair H Herndon, Monsicha Somjit, David L Stahl, Emily Bitticker, John C Coffman
PURPOSE: To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies. SOURCE: An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28137987/diagnostic-performance-of-placental-growth-factor-in-women-with-suspected-preeclampsia-attending-antenatal-facilities-in-maputo-mozambique
#10
U Vivian Ukah, Francisco Mbofana, Beatriz Manriquez Rocha, Osvaldo Loquiha, Chishamiso Mudenyanga, Momade Usta, Marilena Urso, Sharla Drebit, Laura A Magee, Peter von Dadelszen
In well-resourced settings, reduced circulating maternal-free placental growth factor (PlGF) aids in either predicting or confirming the diagnosis of preeclampsia, fetal growth restriction, stillbirth, preterm birth, and delivery within 14 days of testing when preeclampsia is suspected. This blinded, prospective cohort study of maternal plasma PlGF in women with suspected preeclampsia was conducted in antenatal clinics in Maputo, Mozambique. The primary outcome was the clinic-to-delivery interval. Other outcomes included: confirmed diagnosis of preeclampsia, transfer to higher care, mode of delivery, intrauterine fetal death, preterm birth, and low birth weight...
March 2017: Hypertension
https://www.readbyqxmd.com/read/28067720/swept-source-optical-coherence-tomography-evaluation-of-chorioretinal-changes-in-hypertensive-choroidopathy-related-to-hellp-syndrome
#11
Daniel Velazquez-Villoria, Pablo Marti Rodrigo, Maria L DeNicola, Miguel A Zapata Vitori, Antonio Segura García, Jose García-Arumí
PURPOSE: To report a case of hypertensive choroidopathy with detailed chorioretinal images obtained using swept source optical coherence tomography. METHODS: We report the case of a 36-year-old pregnant woman who presented with extensive bilateral exudative retinal detachments (visual acuity of hands movement bilaterally), high blood pressure, and severe alteration of the laboratory test results resulting in the diagnosis of HELLP syndrome. The baby was delivered by emergency cesarean section and the patient was hospitalized in the intensive care unit...
January 6, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28030871/obesity-and-neonatal-cord-blood-gas-results-at-cesarean-effect-of-intraoperative-blood-pressure
#12
Mark F Powell, Charity J Morgan, Jessica A Cantu, Yasser Sakawi, Joseph R Biggio, Alan T N Tita, Jeff M Szychowski, Rodney K Edwards
Objective Our aims were to evaluate whether there is an inverse association between body mass index (BMI) and umbilical artery pH and to investigate the contribution of intraoperative hypotension on the umbilical artery pH. Study Design We conducted a retrospective cohort study of all women with a nonanomalous singleton at 37 to 41 weeks who underwent a scheduled cesarean delivery under spinal anesthesia at our facility from January 2006 to March 2012. The primary outcome was the proportion of patients in each BMI category with arterial cord pH < 7...
December 28, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/28026887/combined-spinal-epidural-anesthesia-with-hypobaric-ropivacaine-in-sitting-position-significantly-increases-the-incidence-of-hypotension-in-parturients-undergoing-cesarean-section
#13
Zhendong Xu, Fuyi Shen, Yueqi Zhang, Yiyi Tao, Xiubing Chen, Zhiqiang Liu
AIM: Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more likely to induce hypotension and higher block level than the lateral position in CSEA with hypobaric ropivacaine. METHODS: Ninety American Society of Anesthesiologists physical status I and II parturients undergoing elective cesarean section were randomized into three groups: the sitting, left-lateral, and right-lateral position groups...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27988917/is-the-perfusion-index-useful-in-early-detection-of-high-spinal-subarachnoid-block-during-cesarean-section
#14
Kazuhide Takeyama, Yosuke Suzuki, Masanobu Yoshikawa, Toshiyasu Suzuki
OBJECTIVE: To investigate the usefulness of the perfusion index (PI) in the early detection of high spinal subarachnoid block (SAB) for cesarean section (CS). METHOD: SAB was applied in patients of CS. The patients was subdivided into two groups, according to the highest level of block: the Ce group (cervical spine level) and the Th group (thoracic spine level). The PI values in the finger and toe, and vital signs were measured at pre- and post-SAB in both groups together with SAB level...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/27987334/echocardiography-findings-in-a-case-with-ballantyne-syndrome
#15
Yutaro Suzuki, Mie Yamamura, Keisuke Kikuchi, Rifumi Hattori, Takeshi Umazume, Hisanori Minakami
Marked fluid retention occurs in Ballantyne syndrome, but few reports are available on changes in cardiac morphology in this syndrome. A woman with generalized edema, dyspnea, fetal hydrops (skin edema and ascites), thickened placenta, and elevated plasma B-type natriuretic peptide level (344 pg/mL) was admitted to our hospital at gestational week (GW) 20(+3) . Blood pressure remained within the normal range. However, acute increases in left atrial volume index, pulmonary artery systolic pressure, and hyperdynamic left ventricular function (as evidenced by increased left ventricular ejection fraction to 74% with cardiac index of 5...
December 17, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27939487/cerebrospinal-fluid-levels-of-tau-and-phospho-tau-181-proteins-during-pregnancy
#16
Wolfgang Lederer, Cristina Alomar Dominguez, Marina Popovscaia, Günther Putz, Christian Humpel
OBJECTIVES: During pregnancy various interactions occur between structural alterations of the maternal brain and placental metabolism. The aim of the present study was to investigate whether cerebrospinal fluid concentrations of tau and phospho-tau-181 protein vary during normal pregnancy and in women with preeclampsia and HELLP syndrome. STUDY DESIGN: We measured cerebrospinal fluid biomarkers, tau and phospho-tau-181 protein levels in 90 pregnant women electively assigned for regional anaesthesia during pregnancy or for cesarean section using enzyme-linked immunosorbent assays...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27873484/pregnant-women-s-perceptions-of-gestational-weight-gain-a-systematic-review-and-meta-synthesis-of-qualitative-research
#17
REVIEW
Meredith Vanstone, Sujane Kandasamy, Mita Giacomini, Deirdre DeJean, Sarah D McDonald
Excess gestational weight gain has numerous negative health outcomes for women and children, including high blood pressure, diabetes, and cesarean section (maternal) and high birth weight, trauma at birth, and asphyxia (infants). Excess weight gain in pregnancy is associated with a higher risk of long-term obesity in both mothers and children. Despite a concerted public health effort, the proportion of pregnant women gaining weight in excess of national guidelines continues to increase. To understand this phenomenon and offer suggestions for improving interventions, we conducted a systematic review of qualitative research on pregnant women's perceptions and experiences of weight gain in pregnancy...
November 21, 2016: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/27871603/prophylactic-phenylephrine-infusion-for-the-prevention-of-hypotension-after-spinal-anesthesia-in-the-elderly-a-randomized-controlled-clinical-trial
#18
Fabrice Ferré, Philippe Marty, Laura Bruneteau, Virgine Merlet, Benoît Bataille, Anne Ferrier, Claude Gris, Matt Kurrek, Olivier Fourcade, Vincent Minville, Agnes Sommet
STUDY OBJECTIVE: Hypotension frequently occurs during spinal anesthesia (SA), especially in the elderly. Phenylephrine is effective to prevent SA-induced hypotension during cesarean delivery. The objective of this study was to evaluate the efficacy and safety of prophylactic infusion of phenylephrine after SA for orthopedic surgery in the elderly. DESIGN: This prospective, randomized, double-blind, and placebo-controlled study included 54 patients older than 60 years undergoing elective lower limb surgery under SA (injection of 10 mg of isobaric bupivacaine with 5 μg of sufentanyl)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871550/carbetocin-for-prevention-of-postcesarean-hemorrhage-in-women-with-severe-preeclampsia-a-before-after-cohort-comparison-with-oxytocin
#19
B Nucci, Agm Aya, E Aubry, J Ripart
STUDY OBJECTIVE: The aim of the study was to compare the incidence of the use of additional uterotonics before and after the change of carbetocin to oxytocin for the prevention of postpartum hemorrhage after cesarean delivery in women with severe preeclampsia. DESIGN: This was an observational retrospective before-and-after study. SETTING: Operating room, postoperative recovery area. PATIENTS: Sixty women with severe preeclampsia undergoing cesarean delivery under spinal anesthesia; American Society of Anesthesiologists 3...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27788933/risk-of-aortic-dissection-in-pregnant-patients-with-the-marfan-syndrome
#20
Rafael Kuperstein, Tal Cahan, Rakefet Yoeli-Ullman, Sagit Ben Zekry, Amihay Shinfeld, Michal J Simchen
Patients with Marfan syndrome (MS) face a high risk of aortic dissection during pregnancy. A dilated aortic root (>40 to 45 mm) is considered a relative contraindication for pregnancy. We investigated the risk for aortic dissection and pregnancy outcome in patients with MS. Women with MS who attended our cardiology high-risk pregnancy clinic from 2006 to 2015 were followed clinically and with serial echocardiograms by a multidisciplinary team. Beta blockers were offered and titrated by blood pressure and heart rate...
January 1, 2017: American Journal of Cardiology
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