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Obstetric Anesthesia

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148 papers 100 to 500 followers Articles of interest for anesthesiologist who work with obstetrics either general or subspecialized
By Ron George Anesthesiologist with special interests in Obstetrics, Pain, and Global Health
https://www.readbyqxmd.com/read/28810392/first-time-fathers-perception-of-their-childbirth-experiences
#1
Anne M Howarth, Kate M Scott, Nicola R Swain
Birth satisfaction impacts on a man's adjustment to his new role as father. Fathers have been found to have needs similar to those of mothers during pregnancy and childbirth. Research suggests that these needs may not be being met for first-time fathers. In a quantitative survey, fathers' birth satisfaction was similar to mothers. This study then used a phenomenological form of thematic analysis to gain an insight into the birth experiences of 155 first-time New Zealand fathers. Core themes included safety of mother and baby, understanding support role, mother in control and managing pain and care and communication after birth...
January 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28802602/labor-analgesia-we-need-to-better-understand-and-educate-our-obstetric-patients
#2
EDITORIAL
Regina Y Fragneto M D, Robert Gaiser M D
No abstract text is available yet for this article.
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28781763/modern-neuraxial-anesthesia-for-labor-and-delivery
#3
REVIEW
Marie-Louise Meng, Richard Smiley
The availability of safe, effective analgesia during labor has become an expectation for women in most of the developed world over the past two or three decades. More than 60% of women in the United States now receive some kind of neuraxial procedure during labor. This article is a brief review of the advantages and techniques of neuraxial labor analgesia along with the recent advances and controversies in the field of labor analgesia. For the most part, we have aimed the discussion at the non-anesthesiologist to give other practitioners a sense of the state of the art and science of labor analgesia in the second decade of the 21st century...
2017: F1000Research
https://www.readbyqxmd.com/read/28753171/informed-consent-and-nitrous-oxide-for-labor-analgesia
#4
Michael G Richardson, Curtis L Baysinger, David H Chestnut
No abstract text is available yet for this article.
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28709410/identification-of-barriers-and-facilitators-for-optimal-cesarean-section-care-perspective-of-professionals
#5
Sonja Melman, Rachel Hellen Petra Schreurs, Carmen Desiree Dirksen, Anneke Kwee, Jan Gerrit Nijhuis, Nicol Anna Cornelia Smeets, Hubertina Catharina Johanna Scheepers, Rosella Petronella Maria Gemma Hermens
BACKGROUND: The cesarean section (CS) rate has increased over recent decades with poor guideline adherence as a possible cause. The objective of this study was to explore barriers and facilitators for delivering optimal care as described in clinical practice guidelines. METHODS: Key recommendations from evidence-based guidelines were used as a base to explore barriers and facilitators for delivering optimal CS care in The Netherlands. Both focus group and telephone interviews among 29 different obstetrical professionals were performed...
July 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28594092/understanding-the-relationship-between-cesarean-birth-and-stress-anxiety-and-depression-after-childbirth-a-nationwide-cohort-study
#6
Hung-Hui Chen, Jerry Cheng-Yen Lai, Shyh-Jou Hwang, Nicole Huang, Yiing-Jenq Chou, Li-Yin Chien
BACKGROUND: Women who undergo cesarean birth might have an increased risk for poor mental health after childbirth, possibly because of maternal and neonatal physical problems, low parental confidence, and decreased levels of oxytocin. However, this relationship remains controversial and requires further examination. The study aimed to examine the effect of cesarean birth on postpartum stress, anxiety, and depression. METHODS: This nationwide population-based cohort study was conducted using the Taiwan National Health Insurance Database...
June 8, 2017: Birth
https://www.readbyqxmd.com/read/28651841/survey-of-nulliparous-parturients-attitudes-regarding-timing-of-epidural-analgesia-initiation
#7
Ghislaine C Echevarria, Gilbert J Grant, Yousun Chung, Jerome Lax
STUDY OBJECTIVE: At our hospital, although >90% of nulliparous parturients eventually choose epidural analgesia for labor, many delay its initiation, experiencing considerable pain in the interim. This survey probed parturients' views about the timing of initiation of epidural labor analgesia. DESIGN: Single-center, nonrandomized quantitative survey. SETTING: Labor and delivery suite in a large tertiary academic medical center. PATIENTS: Two hundred laboring nulliparous women admitted to the labor and delivery suite...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#8
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/23584382/neuraxial-anesthesia-in-parturients-with-intracranial-pathology-a-comprehensive-review-and-reassessment-of-risk
#9
REVIEW
Lisa R Leffert, Lee H Schwamm
Parturients with intracranial lesions are often assumed to have increased intracranial pressure, even in the absence of clinical and radiographic signs. The risk of herniation after an inadvertent dural puncture is frequently cited as a contraindication to neuraxial anesthesia. This article reviews the relevant literature on the use of neuraxial anesthesia in parturients with known intracranial pathology, and proposes a framework and recommendations for assessing risk of neurologic deterioration, with epidural analgesia or anesthesia, or planned or inadvertent dural puncture...
September 2013: Anesthesiology
https://www.readbyqxmd.com/read/22513749/outcomes-of-hospitalization-in-pregnant-women-with-cns-neoplasms-a-population-based-study
#10
Anna R Terry, Fred G Barker, Lisa Leffert, Brian T Bateman, Irene Souter, Scott R Plotkin
Managing a CNS neoplasm during pregnancy presents complex challenges, and population-based studies are lacking. We designed a retrospective cohort study using the Nationwide Inpatient Sample (NIS) to investigate pregnancy outcomes in women with CNS neoplasms. We constructed a logistic regression model for maternal mortality, preterm labor, intrauterine growth restriction (IUGR), and Caesarean delivery, controlling for age, comorbidities, and demographic characteristics. We identified 379 malignant brain tumors, 437 benign brain tumors, and 44 spine tumors among 19 million pregnancy-related admissions from 1988 through 2009...
June 2012: Neuro-oncology
https://www.readbyqxmd.com/read/28622143/epidural-analgesia-at-trial-of-labor-after-cesarean-tolac-a-significant-adjunct-to-successful-vaginal-birth-after-cesarean-vbac
#11
Sorina Grisaru-Granovsky, Maayan Bas-Lando, Lior Drukker, Fred Haouzi, Rivka Farkash, Arnon Samueloff, Alexander Ioscovich
INTRODUCTION: Epidural analgesia has been considered a risk factor for labor dystocia at trial of labor after cesarean (TOLAC) and uterine rupture. We evaluated the association between exposure to epidural during TOLAC and mode of delivery and maternal-neonatal outcomes. MATERIALS AND METHODS: A single center retrospective study of women that consented to TOLAC within a strict protocol between 2006 and 2013. Epidural "users" were compared to "non-users". Primary outcome was the mode of delivery: repeat in-labor cesarean or vaginal birth after cesarean (VBAC)...
June 5, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28622178/labor-analgesia-onset-with-dural-puncture-epidural-versus-traditional-epidural-using-a-26-gauge-whitacre-needle-and-0-125-bupivacaine-bolus-a-randomized-clinical-trial
#12
Sylvia H Wilson, Bethany J Wolf, Kellie N Bingham, Quiana S Scotland, John M Fox, Erick M Woltz, Latha Hebbar
BACKGROUND: Lumbar epidurals (LEs) provide excellent analgesia. Combined spinal epidural and dural puncture epidural (DPE) are 2 techniques to expedite neuraxial analgesia onset. In DPE, dura is punctured but medication is not administered in the cerebrospinal fluid. Expedited analgesia onset has been demonstrated with DPE, using 0.25% bupivacaine; however, this concentration may impede an unassisted vaginal birth and is not currently used for induction and maintenance of labor analgesia...
June 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598915/anesthetic-and-obstetric-management-of-syringomyelia-during-labor-and-delivery-a-case-series-and-systematic-review
#13
REVIEW
Gráinne Patricia Garvey, Vibhangini S Wasade, Kellie E Murphy, Mrinalini Balki
BACKGROUND: Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. METHODS: A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28599396/five-years-experience-in-an-anesthesiology-antenatal-clinic-for-high-risk-patients
#14
Daniel Shatalin, Yaacov Gozal, Sorina Grisaru-Granovsky, Alexander Ioscovich
INTRODUCTION: The aim, of this study is to describe our approach and outcomes in an outpatient anesthesia/analgesia antepartum clinic among ambulatory high-risk obstetric patients. METHODS: This was a retrospective evaluation of the activity of the anesthesiology antenatal clinic from its inception in 2010 until 2016 (a 5-year period). The clinic works in collaboration with the Department of Obstetrics and Gynecology. The catchment area of the study University Affiliated Hospital attends a multiethnic population characterized by high parity...
May 24, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28236650/retrospective-analysis-of-placenta-previa-with-abnormal-placentation-with-and-without-prophylactic-use-of-abdominal-aorta-balloon-occlusion
#15
Shihong Cui, Yunxiao Zhi, Guomei Cheng, Kai Zhang, Lindong Zhang, Linna Shen
OBJECTIVE: To evaluate the effectiveness of prophylactic abdominal aorta balloon occlusion in cases of placenta previa with abnormal placentation. METHODS: In a retrospective study, data were analyzed for patients who had placenta previa with placenta accreta and underwent elective cesarean delivery (>34 weeks) with or without temporary aortic balloon occlusion at a center in Zhengzhou, China, between October 2015 and September 2016. The primary clinical outcomes were operative time, estimated blood loss, intraoperative blood transfusion volume, hemoglobin, hysterectomy, and hospitalization...
June 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28383323/risk-of-epidural-hematoma-after-neuraxial-techniques-in-thrombocytopenic-parturients-a-report-from-the-multicenter-perioperative-outcomes-group
#16
MULTICENTER STUDY
Linden O Lee, Brian T Bateman, Sachin Kheterpal, Thomas T Klumpner, Michelle Housey, Michael F Aziz, Karen W Hand, Mark MacEachern, Christopher G Goodier, Jeffrey Bernstein, Melissa E Bauer
BACKGROUND: Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma. There is limited literature to estimate the risk of epidural hematoma in thrombocytopenic parturients. The authors reviewed a large perioperative database and performed a systematic review to further define the risk of epidural hematoma requiring surgical decompression in this population. METHODS: The authors performed a retrospective cohort study using the Multicenter Perioperative Outcomes Group database to identify thrombocytopenic parturients who received a neuraxial technique and to estimate the risk of epidural hematoma...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28558667/the-meaning-of-labour-pain-how-the-social-environment-and-other-contextual-factors-shape-women-s-experiences
#17
Laura Y Whitburn, Lester E Jones, Mary-Ann Davey, Rhonda Small
BACKGROUND: The majority of women experience pain during labour and childbirth, however not all women experience it in the same way. In order to develop a more complete understanding of labour pain, this study aimed to examine women's experiences within the perspective of modern pain science. A more complete understanding of this phenomenon can then guide the development of interventions to enhance women's experiences and potentially reduce their need for pharmacological intervention...
May 30, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28504988/the-labor-analgesia-requirements-in-nulliparous-women-randomized-to-epidural-catheter-placement-in-a-high-or-low-intervertebral-space
#18
Albert Moore, Valerie Villeneuve, Bruno Bravim, Aly El-Bahrawy, Eva El-Mouallem, Ian Kaufman, Roupen Hatzakorzian, William Li Pi Shan
BACKGROUND: We hypothesized that an epidural catheter placed in a lower vertebral interspace will require less medication for labor analgesia. METHODS: Nulliparous women requesting neuraxial labor analgesia were randomized to epidural catheter placement at the ultrasound-confirmed L1-2 or L4-5 interspace. Patient-controlled epidural analgesia and breakthrough manual epidural boluses of 10 mL of 0.125% bupivacaine with 50 µg of fentanyl or 8 mL of 2% lidocaine were utilized...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28505479/women-s-self-reported-experience-of-unplanned-caesarean-section-results-of-a-swedish-study
#19
Annika Karlström
BACKGROUND: women´s experience of emergency caesarean section is often described as less positive compared to a vaginal birth or a planned caesarean section. Midwifery care for women where deviations from a normal birth process are present is a challenge. The aim of study was to compare self-reported birth outcomes for women undergoing birth through spontaneous onset of labour between those who actually had a vaginal birth and those who eventually had an emergency caesarean section. DESIGN AND SETTING: the study was part of a prospective longitudinal cohort study of parents' experiences, attitudes, and beliefs related to childbirth...
April 27, 2017: Midwifery
https://www.readbyqxmd.com/read/27089000/the-effect-of-intrathecal-morphine-dose-on-outcomes-after-elective-cesarean-delivery-a-meta-analysis
#20
REVIEW
Pervez Sultan, Stephen H Halpern, Ellile Pushpanathan, Selina Patel, Brendan Carvalho
BACKGROUND: The intrathecal morphine dose achieving optimal analgesia for cesarean delivery while minimizing side effects has not yet been deduced. In this meta-analysis, our objective was to determine whether low- or high-dose intrathecal morphine provides acceptable duration and intensity of analgesia with fewer side effects. METHODS: A literature search (PubMed, EMBASE, MEDLINE, Scopus, Web of Science, and CINAHL) was performed to identify randomized controlled trials involving patients undergoing elective cesarean delivery under spinal anesthesia comparing low-dose (LD; 50-100 μg) morphine with higher dose (HD; >100-250 μg)...
July 2016: Anesthesia and Analgesia
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