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Cesarean blood pressure

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https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#1
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28598894/left-lateral-table-tilt-for-elective-cesarean-delivery-under-spinal-anesthesia-has-no-effect-on-neonatal-acid-base-status-a-randomized-controlled-trial
#2
Allison J Lee, Ruth Landau, James L Mattingly, Margaret M Meenan, Beatriz Corradini, Shuang Wang, Stephanie R Goodman, Richard M Smiley
BACKGROUND: Current recommendations for women undergoing cesarean delivery include 15° left tilt for uterine displacement to prevent aortocaval compression, although this degree of tilt is practically never achieved. We hypothesized that under contemporary clinical practice, including a crystalloid coload and phenylephrine infusion targeted at maintaining baseline systolic blood pressure, there would be no effect of maternal position on neonatal acid base status in women undergoing elective cesarean delivery with spinal anesthesia...
June 9, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28554529/maternal-alcohol-exposure-during-mid-pregnancy-dilates-fetal-cerebral-arteries-via-endocannabinoid-receptors
#3
Olga Seleverstov, Ana Tobiasz, J Scott Jackson, Ryan Sullivan, Dejian Ma, J Pierce Sullivan, Steven Davison, Yada Akkhawattanangkul, Danielle L Tate, Terry Costello, Stacey Barnett, Wei Li, Giancarlo Mari, Alex M Dopico, Anna N Bukiya
Prenatal alcohol exposure often results in fetal alcohol syndrome and fetal alcohol spectrum disorders. Mechanisms of fetal brain damage by alcohol remain unclear. We used baboons (Papio spp.) to study alcohol-driven changes in the fetal cerebral artery endocannabinoid system. Pregnant baboons were subjected to binge alcohol exposure via gastric infusion three times during a period equivalent to the second trimester of human pregnancy. A control group was infused with orange-flavored drink that was isocaloric to the alcohol-containing solution...
June 2017: Alcohol
https://www.readbyqxmd.com/read/28535940/-postpartum-hemorrhage-and-pregnancy-induced-hypertension-during-emergency-lower-segment-cesarean-section-dexmedetomidine-to-our-rescue
#4
Uma Hariharan
Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome. It was beneficial in controlling both the blood pressure and uterine bleeding during cesarean section in our patient...
May 20, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28524032/-preoperative-risk-factors-analysis-of-pulmonary-hypertension-crisis-during-perioperative-period-for-caesarean-section-of-woman-with-severe-pulmonary-hypertension
#5
Chunlei Zhang, Yaguang Liu, Enming Qing, Jun Ma
OBJECTIVE: To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value. METHODS: A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. The patients were divided into two groups according to with perioperative PHC or not...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28501278/antenatal-risk-factors-associated-with-need-of-postpartum-antihypertensives-in-women-with-preeclampsia-in-south-india-case-control-study
#6
Anish Keepanasseril, Brajesh Kumar Yadav, Dilip Kumar Maurya
OBJECTIVES: To investigate the antepartum risk factors associated with the need for antihypertensive medication in the postpartum period in women with pre-eclampsia. METHODOLOGY: Matched retrospective case control study was done in a tertiary center in south India between January 2016 and June 2016. We compared 100 preeclamptic women requiring antihypertensive medication in the postpartum period at discharge with 100 preeclamptic women who were not on antihypertensive medication at discharge, matched for age and parity at a ratio 1:1...
April 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28492294/effect-of-remifentanil-for-general-anaesthesia-on-parturients-and-newborns-undergoing-caesarean-section-a-meta-analysis
#7
Yunhui Zhang, Hongmei Lu, Zheng Fu, Huijun Zhang, Ye Li, Wei Li, Jingui Gao
BACKGROUND: The results presented by studies investigating the effect of remifentanil on both parturients and newborns during cesarean section differed significantly. Therefore, we performed a meta-analysis to estimate the effect of remifentanil on these patients. METHODS: Potentially eligible studies published before 15 March 2016 were searched through four databases including PubMed, SCOPUS, ISI web of knowledge and EBSCO. Weighted mean difference (WMD) or odds ratios (ORs) and the corresponding 95% confidence interval (CI) were applied to estimate the strength of relationship...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28451389/effect-of-ephedrine-combined-with-bupivacaine-on-maternal-hemodynamic-and-spinal-nerve-block-in-cesarean-delivery
#8
Mingyue Ge, Sheng Wang, Zhigang Dai, Yan Li, Liping Xie, Xuejao Liu, Jiangwen Yin
The aim of the study was to investigate the effects of ephedrine intrathecal injection on maternal thermodynamics and spinal nerve block in cesarean section. A total of 107 patients undergoing elective cesarean section under combined spinal epidural anesthesia were randomly divided into two groups: group E: Bupivacaine (6 mg) combined with ephedrine (15 mg) and group C: Bupivacaine (6 mg). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), the incidence of hypotension, hypertension, tachycardia, nausea and vomiting were all recorded...
March 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28444286/screening-for-preeclampsia-us-preventive-services-task-force-recommendation-statement
#9
Kirsten Bibbins-Domingo, David C Grossman, Susan J Curry, Michael J Barry, Karina W Davidson, Chyke A Doubeni, John W Epling, Alex R Kemper, Alex H Krist, Ann E Kurth, C Seth Landefeld, Carol M Mangione, William R Phillips, Maureen G Phipps, Michael Silverstein, Melissa A Simon, Chien-Wen Tseng
Importance: Preeclampsia affects approximately 4% of pregnancies in the United States. It is the second leading cause of maternal mortality worldwide and may lead to serious maternal complications, including stroke, eclampsia, and organ failure. Adverse perinatal outcomes for the fetus and newborn include intrauterine growth restriction, low birth weight, and stillbirth. Many of the complications associated with preeclampsia lead to early induction of labor or cesarean delivery and subsequent preterm birth...
April 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28443949/is-reiki-or-prayer-effective-in-relieving-pain-during-hospitalization-for-cesarean-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Guilherme Augusto Rago Ferraz, Meline Rosseto Kron Rodrigues, Silvana Andrea Molina Lima, Marcelo Aparecido Ferraz Lima, Gabriela Lopes Maia, Carlos Alberto Pilan, Michelle Sako Omodei, Ana Cláudia Molina, Regina El Dib, Marilza Vieira Cunha Rudge
CONTEXT AND OBJECTIVE: This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. DESIGN AND SETTING: Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. METHODS: The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL...
March 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28438121/leg-elevation-decreases-the-incidence-of-post-spinal-hypotension-in-cesarean-section-a-randomized-controlled-trial
#11
Ahmed Hasanin, Ahmed Aiyad, Ahmed Elsakka, Atef Kamel, Reham Fouad, Mohamed Osman, Ali Mokhtar, Sherin Refaat, Yasmin Hassabelnaby
BACKGROUND: Maternal hypotension is a common complication after spinal anesthesia for cesarean section (CS). In this study we investigated the role of leg elevation (LE) as a method for prevention of post-spinal hypotension (PSH) for cesarean section. METHODS: One hundred and fifty full term parturients scheduled for CS were included in the study. Patients were randomized into two groups: Group LE (leg elevation group, n = 75) and group C (Control group, n = 75)...
April 24, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28419639/differences-in-intraoperative-hemodynamics-between-spinal-and-general-anesthesia-in-infants-undergoing-pyloromyotomy
#12
Caleb Ing, Lena S Sun, Alexander F Friend, Minjae Kim, Mitchell F Berman, William Paganelli, Guohua Li, Robert K Williams
BACKGROUND: Hypotension and bradycardia are known side effects of spinal anesthesia in pregnant women undergoing cesarean section and adults undergoing other surgical procedures. Whether children experience similar hemodynamic changes is unclear. AIMS: The purpose of this study is to evaluate hemodynamic effects of spinal anesthesia compared to general anesthesia in a cohort of healthy infants. METHODS: The University of Vermont Medical Center almost exclusively used spinal anesthesia for infant pyloromyotomy surgery between 2008 and 2013, while Columbia University Medical Center relied on general anesthesia...
July 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28413279/comparing-slow-and-rapid-bolus-of-ephedrine-in-pregnant-patients-undergoing-planned-cesarean-section-under-spinal-anesthesia
#13
Prabu Gunasekaran, Lenin Babu Elakkumanan, Hemavathi Balachander, M V S Satyaprakash
BACKGROUND AND AIMS: While ephedrine was the preferred drug for treating spinal-induced hypotension in pregnancy, its use has declined because of resultant fetal acidosis. The objective of this randomized control trial was to compare the effects of a slow and rapid bolus of ephedrine on fetal acidosis, maternal blood pressure, and heart rate (HR) during cesarean section performed under spinal anesthesia. MATERIAL AND METHODS: Eighty full-term parturients scheduled for cesarean section under spinal anesthesia were randomly allocated into two groups...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28407656/high-blood-pressure-during-pregnancy-is-not-a-protective-factor-for-preterm-infants-with-very-low-birth-weight-a-case-control-study
#14
Annibal Tagliaferri Sabino, Eduardo de Souza, Ana Lucia Goulart, Adriana Martins de Lima, Nelson Sass
Objective To evaluate whether the presence of maternal blood pressure reduces the risks of morbidity, perinatal mortality and morbidity at 24 months of age in very low birth weight infants (VLBWIs) compared with a control group. Methods A retrospective, observational, case-control study. Total 49 VLBWIs were allocated to the study group, called the maternal arterial hypertension group (AHG), and matched with 44 in the control group (CG). The infants were assessed during hospitalization and at 12 and 24 months corrected age at a specialized clinic...
April 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28368936/closed-loop-feedback-computer-controlled-phenylephrine-for-maintenance-of-blood-pressure-during-spinal-anesthesia-for-cesarean-delivery-a-randomized-trial-comparing-automated-boluses-versus-infusion
#15
Warwick D Ngan Kee, Yuk-Ho Tam, Kim S Khaw, Floria F Ng, Shara W Y Lee
BACKGROUND: We previously described the use of closed-loop feedback computer-controlled infusion of phenylephrine for maintaining blood pressure (BP) during spinal anesthesia for cesarean delivery. In this study, we report a modified system in which phenylephrine is delivered by intermittent boluses rather than infusion. We hypothesized that the use of computer-controlled boluses would result in more precise control of BP compared with infusions. METHODS: Two hundred fourteen healthy patients having spinal anesthesia for elective cesarean delivery were randomized to have their systolic BP maintained by phenylephrine administered by computer-controlled continuous infusion or computer-controlled intermittent boluses...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28331371/vacuum-assisted-cesarean-section
#16
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
#17
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
#18
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
#19
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
#20
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...
July 2017: Anesthesia and Analgesia
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