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https://www.readbyqxmd.com/read/28333816/committee-opinion-no-696-nonobstetric-surgery-during-pregnancy
#1
(no author information available yet)
The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice acknowledges that the issue of nonobstetric surgery during pregnancy is an important concern for physicians who care for women. It is important for a physician to obtain an obstetric consultation before performing nonobstetric surgery and some invasive procedures (eg, cardiac catheterization or colonoscopy) because obstetricians are uniquely qualified to discuss aspects of maternal physiology and anatomy that may affect intraoperative maternal-fetal well-being...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28320344/risk-factors-associated-with-adverse-perinatal-outcome-in-planned-vaginal-breech-labors-at-term-a-retrospective-population-based-case-control-study
#2
Georg Macharey, Mika Gissler, Veli-Matti Ulander, Leena Rahkonen, Mervi Väisänen-Tommiska, Mika Nuutila, Seppo Heinonen
BACKGROUND: Vaginal breech delivery is associated with adverse perinatal outcome. The aim of this study was to identify factors associated with adverse perinatal outcome in term breech pregnancies, and to provide clinicians an aid in selecting women for a trial of vaginal labor with the fetus in breech position. METHODS: We conducted a retrospective, nationwide, Finnish population-based case-control study. All planned singleton vaginal deliveries at term with the fetus in breech position between the years 2005 and 2014 were analyzed...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28277324/risk-factors-for-severe-postpartum-hemorrhage-after-cesarean-delivery-case-control-studies
#3
Alexander J Butwick, Bharathi Ramachandran, Priya Hegde, Edward T Riley, Yasser Y El-Sayed, Lorene M Nelson
BACKGROUND: Women who undergo intrapartum caesarean delivery (CD) are at increased risk of postpartum hemorrhage (PPH) compared with those undergoing prelabor CD. To determine whether the presence and strength of the associations between individual risk factors and severe PPH vary among women undergoing prelabor CD or intrapartum CD, stratified analyses are needed according to CD subtype. METHODS: To identify risk factors for severe PPH within 2 distinct CD populations, prelabor CD and intrapartum CD, we performed 2 case-control studies...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#4
Julio A Jiménez, Elisenda Eixarch, Philip Dekoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia (CDH) defect allows viscera to herniate into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. Antenatal measurement of lung size and liver herniation can predict survival after birth. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion (FETO) under local anesthesia...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28256306/clinical-follow-up-of-pregnancy-in-myasthenia-gravis-patients
#5
Renata D Ducci, Paulo J Lorenzoni, Claudia S K Kay, Lineu C Werneck, Rosana H Scola
This study aimed to analyze the outcome and impact of pregnancy in women with myasthenia gravis (MG). Obstetric and clinical data were retrospectively analyzed before, during and after pregnancy. Predictors of outcome were studied. We included 35 pregnancies from 21 MG patients. In the course of MG symptoms in 30 pregnancies with live births, 50% deteriorated (mainly during the second trimester, p = 0.028), 30% improved, and 20% remained unchanged. The deterioration group had more frequent abnormal repetitive nerve stimulation (RNS) (p = 0...
February 1, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28247115/pregnancy-and-delivery-after-myelomeningocele-repair-ventriculoperitoneal-shunt-implantation-and-augmentation-cystoplasty
#6
Masahiro Kameda, Etsuko Takahara, Motomu Kobayashi, Katsumi Sasaki, Ryuta Morihara, Isao Date
INTRODUCTION: Management of pregnancy and delivery of a patient with a history of myelomeningocele requires a multidisciplinary team approach. CASE REPORT: We report a case of pregnancy and delivery by a patient who had a history of myelomeningocele surgical repair, ventriculoperitoneal (VP) shunt, and bladder augmentation enterocystoplasty. Regarding types of delivery style, anesthesiologists recommended a Cesarean section under general anesthesia. However, urologists recommended a vaginal delivery because they were concerned that she would require a nephrostomy because of severe adhesion between her uterus and the neobladder if she had a Cesarean section...
February 28, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28238025/anesthetic-management-of-abdominal-radical-trachelectomy-for-uterine-cervical-cancer-during-pregnancy
#7
Jun Terukina, Misako Takamatsu, Takayuki Enomoto, Hiroshi Baba
Abdominal radical trachelectomy has been identified as a surgical option for fertility preservation in cervical cancer patients, particularly in pregnant women who strongly desire to continue their pregnancy. Since this procedure requires operating in the uterus, the hardness of the uterus can affect the ease of surgery. Generally, sevoflurane is used for anesthesia in non-obstetric surgery for pregnant women because uterine relaxation is advantageous for uterine blood flow maintenance. However, the use of sevoflurane during radical trachelectomy has not been thoroughly evaluated...
February 25, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28235521/aneurysmal-hemorrhage-in-a-pregnant-patient-with-coarctation-of-aorta-an-anesthetic-challenge
#8
G S Tomar, K Goyal, R Chandran, A Luthra, V Chauhan, N Kumar
A 25years old female patient with pregnancy of 16weeks (G2 P1), diagnosed to have distal anterior cerebral artery aneurysm (DACA) with Hunt & Hess grade I, subarachnoid hemorrhage (SAH) and coexisting atretic type of aortic coarctation posted for aneurysmal clipping under general anesthesia is a challenge to anesthesiologists in perioperative period. Hypertensive surges in a pregnant patient may result in rupture of aneurysms. Mortality in the mothers with CoA has been reported to be in the range of 0 to 9%...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#9
Angela Yates, Craig V Towers, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: We sought to prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early-onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with newborns delivered from mothers without intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28209547/pregnancy-after-urinary-diversion-at-young-ages-risks-and-outcome
#10
Nina Huck, S Schweizerhof, P Honeck, A Neisius, J W Thüroff, R Stein
OBJECTIVE: To assess the urologic and obstetric outcomes during and after pregnancy following urinary diversion (UD) performed during childhood or adolescence. MATERIALS AND METHODS: From our UD database, we identified 25 women who became pregnant between 1981 and 2013. Reasons for UD were neurogenic bladder, exstrophy, trauma, sinus urogenitalis, and interstitial cystitis. Seventeen had continent cutaneous diversion, 4 had continent anal diversion, and 4 had colonic conduit...
February 14, 2017: Urology
https://www.readbyqxmd.com/read/28202311/anesthetic-considerations-for-labor-and-delivery-in-women-with-cerebrospinal-fluid-shunts
#11
S Rajagopalan, S Gopinath, V T Trinh, S Chandrasekhar
BACKGROUND: The anesthetic management of labor and delivery in pregnant women with cerebrospinal fluid shunts can be challenging. We conducted a literature review to understand the anesthetic implications in pregnant women with cerebrospinal fluid shunts. METHODS: We searched PubMed, EMBASE, and Medline databases to identify reports of pregnant women with cerebrospinal fluid shunts during the 30-year period from 1985 to 2015. Twenty-four studies reporting anesthetic techniques for labor and delivery were included in the analyses...
January 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28190371/occupational-radiation-exposure-of-anesthesia-providers
#12
Rachel R Wang, Amanda H Kumar, Pedro Tanaka, Alex Macario
Anesthesia providers are frequently exposed to radiation during routine patient care in the operating room and remote anesthetizing locations. Eighty-two percent of anesthesiology residents (n = 57 responders) at our institution had a "high" or "very high" concern about the level of ionizing radiation exposure, and 94% indicated interest in educational materials about radiation safety. This article highlights key learning points related to basic physical principles, effects of ionizing radiation, radiation exposure measurement, occupational dose limits, considerations during pregnancy, sources of exposure, factors affecting occupational exposure such as positioning and shielding, and monitoring...
February 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28183545/total-intravenous-anesthesia-without-muscle-relaxant-in-a-parturient-with-amyotrophic-lateral-sclerosis-undergoing-cesarean-section-a-case-report
#13
Wei Xiao, Lei Zhao, Fengying Wang, Hong Sun, Tianlong Wang, Guoguang Zhao
Cases of amyotrophic lateral sclerosis with pregnancy are quite rare. The aim of this case report is to present the successful use of total intravenous anesthesia without muscle relaxant for cesarean section in a parturient with amyotrophic lateral sclerosis at 35 weeks' gestation. The parturient presented with impaired neuromuscular function. Titrated general anesthesia with short-acting anesthetics was applied. During the procedure, no muscle relaxant was used. This strategy helped avoid prolonged ventilation and prevent maternal respiratory complications...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28178059/less-restrictive-food-intake-during-labor-in-low-risk-singleton-pregnancies-a-systematic-review-and-meta-analysis
#14
Andrea Ciardulli, Gabriele Saccone, Hannah Anastasio, Vincenzo Berghella
OBJECTIVE: To evaluate benefits and harms of food intake during labor. DATA SOURCES: Electronic databases such as MEDLINE and ClinicalTrials.gov were searched from their inception until October 2016. METHODS OF STUDY SELECTION: We included randomized trials comparing a policy of less-restrictive food intake with a policy of more restrictive food intake during labor. The primary outcome was the mean duration of labor. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of either a relative risk or a mean difference with 95% confidence interval (CI)...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28178055/pulmonary-hypertension-in-pregnancy-a-report-of-49-cases-at-four-tertiary-north-american-sites
#15
Marie-Louise Meng, Ruth Landau, Olof Viktorsdottir, Jennifer Banayan, Tamila Grant, Brian Bateman, Richard Smiley, Elena Reitman
OBJECTIVE: To identify whether pregnancy outcomes vary by etiology and severity of pulmonary hypertension and whether contemporary therapies influence outcomes. METHODS: A retrospective review of medical records at four academic institutions was conducted to identify pregnant women with pulmonary hypertension (2001-2015). International Classification of Diseases, 9th Revision codes for pulmonary hypertension and pregnancy were used to identify potential participants...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28164084/comparison-of-phenylephrine-and-ephedrine-in-treatment-of-spinal-induced-hypotension-in-high-risk-pregnancies-a-narrative-review
#16
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/28151819/epidemiology-of-cardiac-arrest-during-hospitalization-for-delivery-in-canada-a-nationwide-study
#17
Mrinalini Balki, Shiliang Liu, Juan Andrés León, Leyla Baghirzada
BACKGROUND: Cardiac arrest in pregnancy is a rare and devastating condition with high mortality and morbidity. The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, potential etiologies, and survival rates. METHODS: This retrospective population-based study used hospitalization data from the discharge abstract database of the Canadian Institute for Health Information relating to obstetric deliveries in Canada from April 1, 2002, to March 31, 2015...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28138266/pregnancy-after-allogeneic-hematopoietic-stem-cell-transplantation-in-a-fanconi-anemia-patient
#18
Simin Atashkhoei, Solmaz Fakhari, Eissa Bilehjani, Haleh Farzin
Pregnancy in patients with Fanconi anemia (FA) is rare. However, there are reports of successful pregnancy in Fanconi patients after bone marrow transplantation (BMT, hematopoietic stem cell transplantation). We describe the case of a term pregnant woman with FA who was treated with BMT 2 years earlier. She underwent successful delivery with cesarean section using spinal anesthesia without any complications.
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28121644/peripartum-management-of-obstructive-sleep-apnea
#19
Jessica L Booth, Ashley M Tonidandel
The prevalence of obstructive sleep apnea is unknown during pregnancy, but the syndrome is likely underdiagnosed and rising in frequency along with the obesity epidemic. Obstructive sleep apnea is associated with adverse outcomes, including hypertensive disorders of pregnancy, gestational diabetes, preterm, and cesarean delivery. Obese pregnant women should be screened and referred to a sleep medicine specialist for evaluation. Continuous positive airway pressure is the treatment of choice with demonstrated safety and compliance in pregnancy...
January 24, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28116932/-the-risk-factors-of-mood-changing-during-the-perinatal-period
#20
Emőke Adrienn Hompoth, Annamária Töreki, Veronika Baloghné Fűrész, Gábor Németh
INTRODUCTION: The screening of perinatal depression was introduced in Szeged in April 2011. AIM: Our aim was to assess the extent of perinatal mood changing and to explore the risk factors of it. METHOD: Perinatal nurses gave the Edinburgh Postnatal Depression Scale to the 3849 participants four times. RESULTS: In the first trimester were the highest average scores (3.74) and pathological rate (10.8%) compared to the other measurement occasions...
January 2017: Orvosi Hetilap
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