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https://www.readbyqxmd.com/read/29330635/hypotension-due-to-spinal-anesthesia-influences-fetal-circulation-in-primary-caesarean-sections
#1
K Lato, I Bekes, Peter Widschwendter, T W P Friedl, W Janni, F Reister, G Froeba, U Friebe-Hoffmann
PURPOSE: Hypotension due to spinal anesthesia is a well-known side effect in pregnant women receiving caesarean section. Little is known about its impact on fetal blood circulation. METHODS: 40 women with uncomplicated singleton term pregnancies prepared for caesarean section were prospectively evaluated by Doppler sonography before and immediately after spinal anesthesia. RESULTS: In 90% of the women, blood pressure significantly decreased after spinal anesthesia and 42...
January 12, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29325538/influence-of-isoflurane-exposure-in-pregnant-rats-on-the-learning-and-memory-of-offsprings
#2
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
#3
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/29311012/anesthetic-management-of-mosaic-turner-s-syndrome-posted-for-elective-cesarean-delivery-after-spontaneous-pregnancy
#4
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29310326/efficacy-and-safety-of-remifentanil-for-analgesia-in-cesarean-delivery
#5
Xuan Zhou, Lian-Jin Jin, Chun-Yang Hu, Meng Chen, Ying Li, Yue-Shun Zhang
BACKGROUND: This study aimed to assess the efficacy and safety of remifentanil as a general anesthetic during cesarean delivery. MATERIAL AND METHODS: Fifty women with singleton pregnancies undergoing cesarean delivery were randomly divided into intervention and control groups, each group containing 25 subjects. Participants in the intervention group received remifentanil (infused at 2 μg/kg/h), whereas subjects in the control group were given dexmedetomidine (infused at 0...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29305266/pre-emptive-awake-airway-management-under-dexmedetomidine-sedation-in-a-parturient-with-spinal-muscular-atrophy-type-2
#6
C A Godlewski, P F Castellanos
Historically, pregnancy in females with spinal muscular atrophy was contraindicated due to the great risk to the parturient, but with improved management and increased survival more patients are becoming pregnant. We describe the management of a pregnant patient with spinal muscular atrophy type-2, who had severe restrictive lung disease, extensive spinal fusion that precluded neuraxial anesthesia, and chronic respiratory failure on nocturnal Bilevel Positive Airway Pressure. Airway management was further complicated by limited mouth opening and cervical spine ankylosis...
November 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29291413/impact-of-recommended-changes-in-labor-management-for-prevention-of-the-primary-cesarean-delivery
#7
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/29284889/anaesthetic-implications-of-severe-hyperthyroidism-secondary-to-molar-pregnancy-a-case-report-and-review-of-literature
#8
Srinivasan Swaminathan, Roshin Ann James, Rashmi Chandran, Reesha Joshi
Pregnant women with gestational trophoblastic disease have an increased likelihood to develop hyperthyroidism secondary to increased secretion of human chorionic gonadotropin. Most of these cases of hyperthyroidism remain undiagnosed and may present as a thyrotoxic crisis during the perioperative period. Pregnant patients with gestational trophoblastic disease should be always evaluated for hyperthyroidism, and in cases of severe hyperthyroidism, antithyroid treatment should be initiated before evacuation of the mole...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284851/comparison-of-i-gel-versus-endotracheal-tube-in-patients-undergoing-elective-cesarean-section-a-prospective-randomized-control-study
#9
Manohar Panneer, Saravana Babu, Prakash Murugaiyan
Background and Aim: Physiological changes during pregnancy and the sympatho adrenalstimulation during larynoscopy and intubation leads to evaluation of safe devices to secure airway during cesarean section under general anesthesia. I-gel, recently emerging effective supra glottic device found safe during general anesthesia in cesarean section. Aim of the study is to compare the hemodynamic disturbances and airway related complications of I-gel and Endotracheal tube in patients undergoing cesarean section under general anesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29245354/anesthesia-for-a-parturient-with-intraneural-perineurioma-a-case-report
#10
Jiao Li, Hong Zeng, Zhengqian Li, Jun Wang
RATIONALE: Intraneural perineurioma is an extremely rare form of peripheral nerve sheath tumor; and the anesthetic management of a parturient with intraneural perineurioma, especially affecting spinal roots and nerves of extremities, is very rare. PATIENT CONCERNS: A 28-year-old woman was referred to the hospital at 37+5 weeks' gestation, presenting with a 10-year history of paroxysmal acroanesthesia and aching with distal limbs. DIAGNOSES: Based on the biopsy results, including immunohistochemical and electron microscopic findings, and molecular studies, her condition was diagnosed as intraneural perineurioma...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29243058/does-prophylactic-ondansetron-reduce-norepinephrine-consumption-in-patients-undergoing-cesarean-section-with-spinal-anesthesia
#11
Feride Karacaer, Ebru Biricik, İlker Ünal, Selim Büyükkurt, Hakkı Ünlügenç
PURPOSE: Spinal anesthesia-induced hypotension (SAIH) during cesarean delivery is not rare and frequently leads to materno-fetal discrepancy and collapse. More recently, norepinephrine has been proposed for the prevention and treatment of SAIH with fewer tendencies to decrease heart rate and cardiac output. Ondansetron has been reported to reduce the incidence of SAIH in patients undergoing cesarean section. The aim of the present study was to assess the effect of prophylactic ondansetron on the incidence of SAIH, norepinephrine consumption, and adverse effects...
December 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29225748/multiple-exposures-of-sevoflurane-during-pregnancy-induces-memory-impairment-in-young-female-offspring-mice
#12
Woosuk Chung, Seunghwan Yoon, Yong Sup Shin
Background: Earlier studies have reported conflicting results regarding long-term behavioral consequences after anesthesia during the fetal period. Previous studies also suggest several factors that may explain such conflicting data. Thus, we examined the influence of age and sex on long-term behavioral consequences after multiple sevoflurane exposures during the fetal period. Methods: C57BL/6J pregnant mice received oxygen with or without sevoflurane for 2 hours at gestational day (GD) 14-16...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29189893/maternal-hemodynamics-in-late-gestation-and-immediate-postpartum-in-singletons-vs-twin-pregnancies
#13
Anat Lavie, Maya Ram, Shaul Lev, Yair Blecher, Uri Amikam, Yael Shulman, Tomer Avnon, Eran Weiner, Ariel Many
PURPOSE: Differences in hemodynamic changes during a cesarean section (CS) between twin and singleton pregnancies are poorly defined. The Non-Invasive Cardiac System (NICaS) is an impedance device that measures cardiac output (CO) and its derivatives. We compared maternal cardiac parameters using NICaS™ in singleton and twins before and during delivery, as well at the early puerperium in healthy women undergoing CS at term. METHODS: This prospective longitudinal study included women with twin (n = 27) or singleton pregnancies (n = 62) whose hemodynamic parameters were assessed by NICaS before an elective CS, after spinal anesthesia, immediately after delivery, after fascia closure, and within 24-36 and 48-72 h postpartum...
November 30, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#14
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29128165/in-reply-to-salman-mm-goetze-n-badrinath-m-shah-m-the-videolaryngoscope-as-a-first-line-intubation-device-in-women-with-hypertensive-disease-of-pregnancy-international-journal-of-obstetric-anesthesia-2017-33-doi-http-dx-doi-org-10-1016-j-ijoa-2017-07-005
#15
https://www.readbyqxmd.com/read/29125378/type-of-obstetric-anesthesia-administered-and-complications-in-women-with-preeclampsia-in-low-and-middle-income-countries-a-systematic-review
#16
Soha Sobhy, Kuhan Dharmarajah, David Arroyo-Manzano, Ramesan Navanatnarajah, James Noblet, Javier Zamora, Shakila Thangaratinam
BACKGROUND: Delivery is often expedited with cesarean section, necessitating anesthesia, to prevent complications in women with preeclampsia. Anesthesia-associated risks in these women from low- and middle-income countries (LMICs) are not known. METHODS: We searched major databases (until February 2017) for studies on general vs. regional anesthesia in women with preeclampsia. We summarized the association between outcomes and type of anesthesia using a random effects model and reported as odds ratio (OR) with 95% confidence intervals (95% CIs)...
November 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/29122557/-maternal-deaths-due-to-anesthesia-complications-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#17
D Chassard
Over the period 2010-2012, maternal mortality linked to anesthesia accounted for 2% of maternal deaths, with no significant change since 2007-2009. Of the 7 maternal deaths analyzed by the expert committee, anesthetic complications were in 5 cases the main cause of death: 4 attributed to direct causes related to anesthetic procedures during childbirth and 1 to indirect cause in connection with an ENT complication during pregnancy. The anesthetic causes of maternal mortality were for the 2010-2012 period: cardiac arrest under spinal anesthesia during caesarean section, local anesthetic intoxication with unsuccessful resuscitation after cardiac arrest without intralipid administration, acute respiratory distress syndrome in the postpartum period after pulmonary aspiration during caesarean section, cardiac arrest during caesarean section under general anesthesia in a context of non-Hodgkin lymphoma with mediastinal syndrome, unsuccessful endotracheal intubation in a context of cellulitis of the oral cavity floor...
November 6, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29109631/comparative-evaluation-of-midazolam-dexmedetomidine-and-propofol-as-intensive-care-unit-sedatives-in-postoperative-electively-ventilated-eclamptic-patients
#18
Malik Rameez Rashid, Rukhsana Najeeb, Saima Mushtaq, Rizwana Habib
Background and Aims: Eclampsia is a common hypertensive disorder of pregnancy and treatment often includes termination of pregnancy with elective postoperative mechanical ventilation. The present study was aimed to compare midazolam, propofol, and dexmedetomidine for sedation and antihypertensive requirements of such patients admitted to Intensive Care Unit (ICU) after termination of pregnancy. Material and Methods: A total of ninety eclamptic patients administered general anesthesia for the termination of pregnancy through cesarean section and who also required postoperative ventilation were taken up for the study and were randomly allocated into three groups...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107309/pain-management-in-obstetrics
#19
REVIEW
Jennifer G Hensley, Michelle R Collins, Claire L Leezer
Critical care clinicians may be called on to care for a laboring woman. Comprehension of the anatomic changes associated with pregnancy, and labor and birth, is essential. A working knowledge of the current options for pain management in labor, both pharmacologic and nonpharmacologic, is necessary to facilitate patient-centered care. Pharmacologic options include intravenous or intramuscular agents, inhalational agents, and neuraxial anesthesia. Each modality has contraindications, risks, and benefits that must be considered when choosing the most appropriate method...
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29099429/the-society-for-obstetric-anesthesia-and-perinatology-consensus-statement-on-the-anesthetic-management-of-pregnant-and-postpartum-women-receiving-thromboprophylaxis-or-higher-dose-anticoagulants
#20
Lisa Leffert, Alexander Butwick, Brendan Carvalho, Katherine Arendt, Shannon M Bates, Alex Friedman, Terese Horlocker, Timothy Houle, Ruth Landau, Heloise Dubois, Roshan Fernando, Tim Houle, Sandra Kopp, Douglas Montgomery, Joseph Pellegrini, Richard Smiley, Paloma Toledo
Venous thromboembolism is recognized as a leading cause of maternal death in the United States. Thromboprophylaxis has been highlighted as a key preventive measure to reduce venous thromboembolism-related maternal deaths. However, the expanded use of thromboprophylaxis in obstetrics will have a major impact on the use and timing of neuraxial analgesia and anesthesia for women undergoing vaginal or cesarean delivery and other obstetric surgeries. Experts from the Society of Obstetric Anesthesia and Perinatology, the American Society of Regional Anesthesia, and hematology have collaborated to develop this comprehensive, pregnancy-specific consensus statement on neuraxial procedures in obstetric patients receiving thromboprophylaxis or higher dose anticoagulants...
November 1, 2017: Anesthesia and Analgesia
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