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pregnancy anesthesia

Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
October 3, 2016: Anesthesia and Analgesia
Akwugo A Eziefule, Solafa Elshatanoufy, Mili Thakur, Frederico G Rocha
Background Propofol is a widely known, commonly used drug. Complications can occur with the use of this drug, including propofol-related infusion syndrome (PRIS). PRIS, in the obstetric population, has not been documented; however, we report a case of a patient who developed PRIS after an emergent cesarean delivery of a preterm infant. Case Study A 35-year-old multigravida woman presented complaining of leakage of fluid and decreased fetal movement. Her pregnancy was complicated by methadone maintenance therapy due to a history of opioid abuse...
October 2016: American Journal of Perinatology Reports
Giuseppe Falco, Monica Foroni, Fabio Castagnetti, Luigi Marano, Daniele Bordoni, Nicola Rocco, Vanessa Marchesi, Valentina Iotti, Rita Vacondio, Guglielmo Ferrari
INTRODUCTION: Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation. MATERIAL AND METHODS: 34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess...
October 11, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Joanna Davies, Rezan Kadir
Management of factor XI (FXI) deficiency in pregnancy is complicated by lack of correlation between FXI level and bleeding risk. Clinicians should be vigilant about the potential for prolonged or excessive bleeding following miscarriage or termination of pregnancy, or postpartum hemorrhage (PPH). A multidisciplinary approach along with an individual care plan is recommended to prevent bleeding complications. Assessment of bleeding history, FXI level, and global tests of hemostasis can aid management decisions regarding hemostatic prophylaxis...
October 3, 2016: Seminars in Thrombosis and Hemostasis
Chukwudi O Chiaghana, Justin M Bremer, Joshua W Sappenfield, Adam L Wendling
OBJECTIVE: Neuraxial hematoma is a rare complication of spinal or epidural anesthesia. However, variable coagulation factor defects are relatively common in patients with Fontan circulation, and may predispose such patients to either increased risk of thrombosis or coagulopathy. These defects may indirectly increase their risk of neuraxial hematoma. CASE REPORT: We report a case of delayed neuraxial hematoma after the start of full-dose anticoagulation for pulmonary embolus on a postpartum patient with Fontan physiology who had continuous spinal anesthesia for cesarean delivery 4 days earlier...
September 22, 2016: Regional Anesthesia and Pain Medicine
Amit Meshi, Sharon Armarnik, Michael Mimouni, Fani Segev, Ori Segal, Hagai Kaneti, Ehud I Assia, Noa Geffen
PURPOSE: To investigate the effect of modern vaginal labor using epidural anesthesia on the intraocular pressure (IOP) and on the mean ocular perfusion pressure (MOPP) in healthy women. PATIENTS AND METHODS: In this prospective observational study, eligible candidates were healthy pregnant women for vaginal delivery with epidural anesthesia, with a singleton pregnancy, who were admitted to the delivery room in the first phase of the first stage of labor. Demographic data as well as medical and obstetric history were obtained at baseline, followed by performance of a biomicroscopic examination...
September 21, 2016: Journal of Glaucoma
Susan F Wilson, Elizabeth P Gurney, Mary D Sammel, Courtney A Schreiber
BACKGROUND: Women undergoing office-based surgical management of a failed or undesired pregnancy often report fear of pain and anxiety pertaining to the procedure. Doulas are trained to specifically address women's physical and emotional needs in obstetric care, and recently have extended their practice to support women through all pregnancy outcomes. OBJECTIVE: We sought to evaluate the impact of doulas on patients' physical and emotional responses to surgical management of a first-trimester failed or undesired pregnancy under local anesthesia...
September 6, 2016: American Journal of Obstetrics and Gynecology
Serap Köybaşı Şanal, Yusuf Özgür Biçer, Aysel Kükner, Erkan Tezcan
BACKGROUND: Voice may be affected during the period of pregnancy, especially in the third trimester. However, the exact mechanisms leading to the phonatory changes have not yet uncovered. AIMS: The aim of this study is to investigate the possible histological changes in the vocal cords of the pregnant rats in three separate trimesters. STUDY DESIGN: Animal experiment. METHODS: Twenty-five Wistar-Albino female rats were divided into four groups: control group, pregnancy day 7 (Group 1), pregnancy day 14 (Group 2) and pregnancy day 20 (Group 3)...
July 2016: Balkan Medical Journal
Helbert Eustáquio Cardoso da Silva, Erika do Socorro Ramos Costa, Antônio Carlos Quintão Medeiros, Paulo Sérgio Dos Santos Pereira
BACKGROUND: Ameloblastomas are rarely found in pregnant women, with only two cases reported in the scientific literature. We report the first case of ameloblastoma in a pregnant woman in Brazil. CASE PRESENTATION: A 27-year-old white woman, 12-weeks pregnant, presented with a large mass in her right posterior mandible. Panoramic radiography revealed a lesion involving her mandibular right first molar with displacement of her mandibular right third molar and impairment of the mandibular bone base...
2016: Journal of Medical Case Reports
Mohammad Reza Razeghinejad, Masoumeh Masoumpour, Mohammad Hossein Eghbal, Jonathan S Myers, Marlene R Moster
Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed...
September 2016: Iranian Journal of Medical Sciences
Minh-Bao Mundschenk, Emily M Krauss, Louis H Poppler, Jessica M Hasak, Mary E Klingensmith, Susan E Mackinnon, Marissa M Tenenbaum
BACKGROUND: Perceptions of residents regarding pregnancy during training were compared over time and across surgical, internal medicine, obstetrics/gynecology, and anesthesia specialties. METHODS: A single-institution survey was distributed to female residents in 2008 and to female and male residents in 2015. Nonparametric comparisons of Likert scale response distributions were performed on the supportiveness for pregnancy of the residency program and childbearing influences of female residents in 2008 and 2015, between specialties for each survey year, and between male and female residents in 2015...
October 2016: American Journal of Surgery
Varun Puvanesarajah, Andrea M Spiker, Brett A Shannon, Maureen Grundy, Adam S Levin, Carol D Morris
Primary musculoskeletal cancer and metastatic disease to bone in pregnant patients presents major treatment challenges. Although uncommon, musculoskeletal malignancies in pregnant women have been reported. When diagnosing and treating these patients, the mother's health must be managed appropriately while ensuring that fetal development is not deleteriously affected. Extensive radiographic imaging and more advanced techniques are often necessary to fully characterize the extent of disease. When possible, magnetic resonance imaging should be used instead of computed tomography to limit exposure of the conceptus to radiation...
September 2016: Surgical Oncology
J Sun, H Zeng, Y Q Wang, Y Y Zhao
Takayasu's arteritis is a rare, idiopathic, chronic inflammatory disease. Its course is unpredictable, but slow progression is usual, leading to stenosis, occlusion, or aneurismal degeneration of the aorta or its major branches. We present the anesthesia management of pregnancy in four women admitted to Peking University Third Hospital for caesarean section from year 2006 to 2015 complicated with Takayasu's arteritis and review this disease with special reference to natural history, diagnostic criteria, classification, prognostic factors, and anesthesia considerations...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Solwayo Ngwenya
INTRODUCTION: The complications of HIV/AIDS can produce grossly abnormal pathology. In low-resourced settings, women can present late with huge lesions. Massive vulval pathology copresenting in pregnancy produces difficulties in managing the patients and may lead to poor maternal or fetal outcomes. CASE REPORT: A 27-year-old P1 G2 (second pregnancy one live birth) patient presented at 30 weeks gestation with a massive vulval lesion. She was HIV seropositive and taking anti-retroviral therapy...
2016: International Medical Case Reports Journal
Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, José Hélio Zen Junior, Maria José Nascimento Brandão, Giancarlo Antonio Marcondes, Thales Daniel Alves Barbosa
: Insulinoma is a functional neuroendocrine tumor derived from beta cells of the pancreatic islets of Langerhans, usually solitary, benign, and curable with surgery (enucleation). It rarely occurs during pregnancy and is clinically manifested by hypoglycemia, particularly in the first trimester of pregnancy. During pregnancy, both conservative therapeutic measures (medication) and surgical treatment are challenging regarding the impossibility of studies on drug teratogenicity as well as the maternal-fetal repercussions during surgery, such as hypoglycemia and changes due to stress...
August 11, 2016: Revista Brasileira de Anestesiologia
B Pehlivanov, M Matev
We report a case of a 34 years old primigravida with Charcot-Marie-Tooth disease (CMTD). The course of pregnancy was uneventful with no deterioration of symptoms due to the disease. Performed amniocentesis showed healthy fetus. Planned cesarean section with spinal anesthesia was performed because of the restricted pelvis. The possible issues of combination pregnancy and CMTD are discussed.
2016: Akusherstvo i Ginekologii︠a︡
Agnieszka Baranowska, Beata Skowron, Katarzyna Ciesielczyk, Justyna Domagała, Piotr J Thor
INTRODUCTION: High-calorie diet is responsible for excessive weight gain. Obesity has recently become world epidemics, affecting not only adults but also children, which makes it the biggest health problem in the world. Yet the underlying mechanism remains a matter of debate. OBJECTIVES: The aim of this study is to clarify the role of gender in high fat diet induced obesity in pups and adult animals. MATERIALS AND METHODS: Female rats were fed low/ high fat diet during mating, pregnancy and lactation...
2016: Folia Medica Cracoviensia
P Chaveeva, V Stratieva, H Shivachev, S Aktash, M Panova, A Shterev
ABSTRACT OBJECTIVE: To present a case of macrocystic type cystic adenomatoid malformation of the lung (CCAM) treated with thoraco-amniotic shunt and to review the published data to evaluate the efficiency of thoraco-amniotic shunts for drainage of (CCAM). MATERIALS AND METHODS: This wass case reported of a fetus with a large thoracic cyst, major mediastinal shift and polyhidramnion treated with thoraco-amniotic shunting. We identified 8 cases diagnosed with CCAM and only one case met the criteria for fetal surgery...
2016: Akusherstvo i Ginekologii︠a︡
A T Dennis, S M Mulligan
OBJECTIVE: We determined pain experience and analgesic usage in women with preeclampsia (PE) after caesarean section (CS). METHOD: We conducted a one-year retrospective case (PE), control (healthy pregnancy HP) study in women undergoing CS. RESULTS: Sixty-two women were included. Cases received more intrathecal bupivacaine (mean difference 0.4 mg) and in the first six hours postoperatively received (mean ± SD, % or median (interquartile range, IQR)), less oxycodone (11...
July 28, 2016: Hypertension in Pregnancy
Sabrina N Pavri, James Clune, Stephan Ariyan, Deepak Narayan
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Discuss the initial management of cutaneous malignant melanoma with regard to diagnostic biopsy and currently accepted resection margins. 2. Be familiar with the management options for melanoma in specific situations such as subungual melanoma, auricular melanoma, and melanoma in the pregnant patient. 3. Discuss the differentiating characteristics of desmoplastic melanoma and its treatment options. 4...
August 2016: Plastic and Reconstructive Surgery
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