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https://www.readbyqxmd.com/read/29769490/comparison-of-outcome-of-eclamptic-patient-following-vaginal-delivery-versus-caeserian-delivery-by-spinal-anaesthesia
#1
M A Hossain, R K Karmoker, M S Rahman, H O Rashid, S H Khan, M A Rahman
Eclampsia is a common problem in pregnancy in Bangladesh. It is a severe form of preeclampsia which affects 5 to 7% of pregnancies is a significant cause of maternal & neonatal morbidity & mortality. Pre-eclampsia when complicated with generalized tonic-clonic convulsions and/or coma is called eclampsia. The term eclampsia is derived from a Greek word, meaning "like a flash of lightening". It may occur quite abruptly, without any warning manifestations. Eclampsia is a major cause of maternal mortality & morbidity as well as foetal loss worldwide, particularly in the third world...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29768321/anesthetic-management-of-cesarean-delivery-for-a-parturient-with-wilson-s-disease-a-case-report
#2
Yantong Wan, Xiaoqin Jiang, Xuemei Lin
RATIONALE: Wilson's disease (WD), or hepatolenticular degeneration, is an autosomal recessive disorder with a prevalence of 1:50,000 to 1:100,000 live births. PATIENT CONCERNS: A 26-year-old primipara with WD was admitted to our hospital, due to awaiting delivery. Her main symptoms were slightly higher total bile acid (TBA) and bilateral depressed edema of lower limbs. DIAGNOSIS: She was at 38 weeks and 4 days of gestation with a 15-year history of WD, controlled with penicillamine in the past and replaced by zinc preparations from three months before pregnancy...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764714/bronchoscopic-resection-of-a-tracheobronchial-leiomyoma-in-a-pregnant-patient
#3
K Falce, E Guy, D Hyman, T Hotze, D Lazarus, V Bandi, J Parchem, C Davidson, U Munnur
Flexible bronchoscopy, therapeutic bronchoscopy and other procedures requiring anesthesia are generally avoided in pregnancy and postponed until after delivery if possible. We report a case of a parturient with an abnormal chest radiograph and mild obstructive symptoms of unknown etiology. At bronchoscopy, a tumor associated with post-obstructive suppuration was found and excised using electrocautery snare and cryotherapy, for restoration of airway patency. Coordination between pulmonary, obstetric, anesthesia, neonatology and thoracic surgery services was essential in ensuring success and the safety of the mother and fetus...
April 10, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29742696/acute-starvation-ketoacidosis-in-pregnancy-with-severe-hypertriglyceridemia-a-case-report
#4
Li Hui, Li Shuying
RATIONALE: Pregnant women are more prone to ketosis due to the relative insulin resistance, accelerated lipolysis and increased free fatty acids. PATIENT CONCERNS: We report a pregnant woman with hyperlipidemia, who experienced severe metabolic acidosis after a short period of starvation. DIAGNOSES: Based on her clinical symptoms, exclusion diagnosis and therapeutic diagnosis, her condition was diagnosed as starvation ketoacidosis. INTERVENTIONS: An emergency caesarean section under general anesthesia was implemented 2 hours after her admission...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29732167/bugs-in-the-program-can-pregnancy-drugs-and-smoking-disturb-molecular-reprogramming-of-the-fetal-germline-increasing-heritable-risk-for-autism-and-neurodevelopmental-disorders
#5
Jill Escher
In a seeming paradox, the prevalence of autism spectrum disorder (ASD) has surged, while at the same time research has pointed to the strong heritability of this neurodevelopmental pathology. Here an autism research philanthropist suggests a biological phenomenon of exogenously induced 'gamete disruption' that could reconcile these seemingly contradictory observations. Mining information from her own family history and that of her fellow autism parents, while also engaging with the scientific community, she proposes that a subset of the autisms may be rooted in a variety of molecular glitches in parental gametes induced by certain acute exposures during the parents' own fetal or neonatal development...
April 2018: Environmental Epigenetics
https://www.readbyqxmd.com/read/29673659/effect-of-epidural-anesthesia-in-labor-pregnancy-with-cardiovascular-disease
#6
Hiroaki Tanaka, Chizuko Kamiya, Shinji Katsuragi, Kayo Tanaka, Jun Yoshimatsu, Tomoaki Ikeda
OBJECTIVE: We studied the effect and safety of epidural anesthesia during labor in pregnant women with cardiovascular disease. MATERIALS AND METHODS: In the pregnant women with cardiovascular disease, we compared maternal outcome and suppressive effect on blood pressure retrospectively between the epidural group (anesthetized epidurally during labor) and the no-epidural group (not anesthetized epidurally during labor). RESULTS: A total of 277 patients were included in the analyses...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29672287/early-administration-of-magnesium-sulfate-during-open-fetal-myelomeningocele-repair-reduces-the-dose-of-inhalational-anesthesia
#7
Roopali Donepudi, Melissa Huynh, Kenneth J Moise, Ramesha Papanna, Anthony Johnson, Mary Austin, KuoJen Tsao, Ranu Jain
INTRODUCTION: Optimal uterine relaxation is achieved through higher minimum alveolar concentration (MAC) of inhalational anesthetics, increasing risks to mother and fetus. Our objective was to determine if earlier administration of magnesium sulfate would reduce the requirement of inhalational anesthetics in fetal myelomeningocele repair. MATERIALS AND METHODS: Prospective observational study of fetal myelomeningocele repair was performed from September 2011 to August 2017...
April 19, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29664053/labor-onset-oxytocin-use-and-epidural-anesthesia-for-vaginal-birth-after-cesarean-section-and-associated-effects-on-maternal-and-neonatal-outcomes-in-a-tertiary-hospital-in-china-a-retrospective-study
#8
Shao-Wen Wu, He Dian, Wei-Yuan Zhang
Background: In the mainland of China, the trial of labor after cesarean section is still a relatively new technique. In this study, we aimed to investigate the effects of labor onset, oxytocin use, and epidural anesthesia on maternal and neonatal outcomes for vaginal birth after cesarean section (VBAC) in a tertiary hospital in China. Methods: This was a retrospective study carried out on 212 VBAC cases between January 2015 and June 2017 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29630132/effects-of-sevoflurane-or-propofol-combined-with-remifentanil-anesthesia-on-clinical-efficacy-and-stress-response-in-pregnant-women-with-pregnancy-induced-hypertension
#9
L-Q Ren, X-X Sun, Y Guan
OBJECTIVE: To compare the effects of sevoflurane or propofol combined with remifentanil anesthesia on the clinical efficacy and stress response of pregnancy-induced hypertension (PIHS) in cesarean section. PATIENTS AND METHODS: 150 patients with PIHS and treated with cesarean section in our hospital from May 2015 to September 2016 were selected. All patients were randomly divided into sevoflurane-remifentanil group (n=75) and propofol-remifentanil (n=75). The elbow blood of patients in both groups were collected, the levels of Norepinephrine (NE) adrenaline (AD), cortisol and blood glucose in plasma were compared at before anesthesia induction (T0), operation 30 min (T1), end of operation (T2), 2 h after operation (T3), 24 h after operation (T4)...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29608321/management-of-pregnancy-sensitized-with-anti-inb-with-monocyte-monolayer-assay-and-maternal-blood-donation
#10
Raj Shree, Kimberly K Ma, Lay S Er, Meghan Delaney
Maternal red blood cell (RBC) alloantibodies can cause hemolytic disease of the fetus and newborn (HDFN). Although much is described about common antibodies associated with HDFN, management of a pregnancy complicated by a maternal rare antibody presents several challenges related to assessment of fetal anemia risk, availability of blood for transfusion to the mother and/or the fetus or newborn if needed, and planning for delivery in the case of maternal hemorrhage. Here we report the laboratory medicine workup of a patient who presented for obstetrical care in the United States in the third trimester and had a rare antibody (anti-Inb)...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29604954/an-intramural-uterine-fibroid-became-submucosal-in-the-puerperium-proposed-probable-mechanism-a-case-report
#11
Elie Nkwabong
BACKGROUND: Vaginal prolapse of a large uterine fibroid is a rare phenomenon in a woman who delivered vaginally recently, given that this fibroid might have obstructed labor. The author presents a case report of a vaginally prolapsed large pedunculated submucosal uterine myoma in a woman with a recent uncomplicated vaginal delivery. CASE PRESENTATION: A 25-year-old black African woman had four intramural uterine fibroids of diameters 62 to 94 mm diagnosed in April 2013 with standard ultrasound scan...
April 1, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#12
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29560763/pre-and-peripartal-management-of-a-woman-with-mcardle-disease-a-case-report
#13
Tina Stopp, Michael Feichtinger, Wolfgang Eppel, Thomas M Stulnig, Peter Husslein, Christian Göbl
McArdle disease or glycogen storage disease (GSD) type V is a rare autosomal recessive inherited disorder in skeletal muscle metabolism leading to exercise intolerance, muscle cramps and in some cases to rhabdomyolysis and acute renal failure due to elevated serum myoglobin levels. Albeit the uterine smooth muscle is not affected, pregnancy and delivery can be physically strenuous and may require specific anesthesiologic care. However, data on pregnancy progress and outcome and on special implications linked to anesthesia in women with McArdle's disease is scarce, thus posing a challenge to pre- and peripartal management...
March 21, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29551095/concurrent-medical-conditions-among-pregnant-women-ignore-at-their-peril-report-from-an-antenatal-anesthesia-clinic
#14
Carolyn F Weiniger, Sharon Einav, Uriel Elchalal, Vladislav Ozerski, Daniel Shatalin, Alexander Ioscovich, Yehuda Ginosar
BACKGROUND: Care of pregnant women with concurrent medical conditions can be optimized by multidisciplinary antenatal management. In the current study we describe women with concurrent medical conditions who attended our antenatal anesthesia clinic over a 14-year period, 2002-2015 and, based on the findings, we suggest new policies, strategies and practices to improve antenatal care. METHODS: In 2002, an antenatal anesthesia clinic was established in Hadassah Medical Center...
March 19, 2018: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29550867/non-sedation-of-the-neonate-for-radiologic-procedures
#15
REVIEW
Richard B Parad
On Dec. 16, 2016, the U.S. Food and Drug Administration (FDA) released a warning regarding the potential neurotoxicity of anesthesia and sedation agents on the developing brain in children younger than 3 years and in women during their 3rd trimester of pregnancy. These concerns have relevance to the pediatric radiologist who must take into consideration how the child's state might impact image quality. In this review the author provides background on the special concerns in the potentially highest-risk group, pre-term and term neonates, and provides guidance and rationale for the avoidance of sedation in procedural imaging of the newborn...
April 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29535558/aplastic-anemia-during-pregnancy-a-review-of-obstetric-and-anesthetic-considerations
#16
REVIEW
Efrain Riveros-Perez, Amy C Hermesch, Linda A Barbour, Joy L Hawkins
Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#17
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
https://www.readbyqxmd.com/read/29525197/perioperative-management-of-pregnant-women-with-idiopathic-pulmonary-arterial-hypertension-an-observational-case-series-study-from-china
#18
Jinglan Zhang, Jiakai Lu, Xiaorui Zhou, Xuefeng Xu, Qing Ye, Qitan Ou, Yanna Li, Jiapeng Huang
OBJECTIVES: The mortality of pregnant women with idiopathic pulmonary arterial hypertension (PAH) is very high. There are limited data on the management of idiopathic PAH during pregnancy. The authors aimed to examine systematically the characteristics of parturient women with idiopathic PAH, to explore the adverse effects of idiopathic PAH on pregnancy outcomes, and to report the multidisciplinary perioperative management strategy from the largest comprehensive cardiac hospital in China...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29506860/-anesthesia-for-cesarean-delivery-in-a-patient-with-klippel-trenaunay-syndrome
#19
Clara Elisa Frare de Avelar Teixeira, Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho, Rafael Miranda da Costa, Giselle Ioná Teixeira Brighenti
INTRODUCTION: Klippel-Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetric risk. CASE REPORT: Female patient, 29 years old, 99kg, 167cm, BMI 35.4kg.m-2 , physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel-Trenaunay syndrome...
March 2, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29492141/management-of-obstructive-hydrocephalus-in-pregnant-patient
#20
Murat Şakir Ekşi, Ahmet Öğrenci, Osman Ersegun Batçık, Orkun Koban
De novo obstructive hydrocephalus is a rare event during pregnancy. There are only case reports presented in literature. We aimed to discuss the pathophysiological basis and management options with an exemplary case presentation and review of the current literature. A 28-year-old G2P1 patient presented to our clinic with headache, vomiting, and deteriorated vision at the 8th week of gestation. She had no history of central nervous system infection or trauma. A brain magnetic resonance imaging was obtained. There was hydrocephalus due to cerebral aqueduct stenosis (Evan's index of 58%)...
January 2018: Asian Journal of Neurosurgery
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