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Obstetric Anesthesia

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170 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/29135590/the-analgesic-effect-of-ultrasound-guided-quadratus-lumborum-block-after-cesarean-delivery-a-randomized-clinical-trial
#1
Anders Krohg, Kyrre Ullensvang, Leiv Arne Rosseland, Eldrid Langesæter, Axel R Sauter
BACKGROUND: Landmark and ultrasound-guided transversus abdominis plane blocks have demonstrated an opioid-sparing effect postoperatively after cesarean delivery. The more posterior quadratus lumborum (QL) might provide superior local anesthetic spread to the thoracolumbar fascia and paravertebral space. The aim of our study was to evaluate the efficacy of the QL block after cesarean delivery. METHODS: A randomized, double-blind, controlled trial was performed. Forty parturients undergoing cesarean delivery received bilateral ultrasound-guided QL blocks with either 2 mg/mL ropivacaine or saline postoperatively...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29128739/childbirth-and-parenting-preparation-in-antenatal-classes
#2
M Barimani, K Forslund Frykedal, M Rosander, A Berlin
OBJECTIVES: to describe topics (1) presented by midwives' during antenatal classes and the amount of time spent on these topics and (2) raised and discussed by first-time parents and the amount of time spent on these topics. DESIGN: qualitative; data were gathered using video or tape recordings and analysed using a three-pronged content analysis approach, i.e., conventional, summative, and directed analyses. SETTING AND PARTICIPANTS: 3 antenatal courses in 2 antenatal units in a large Swedish city; 3 midwives; and 34 course participants...
October 31, 2017: Midwifery
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
#3
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/29090735/learning-from-the-law-a-review-of-21%C3%A2-years-of-litigation-for-pain-during-caesarean-section
#4
K McCombe, D G Bogod
The large majority of caesarean sections in the UK are now carried out under neuraxial anaesthesia. Although this technique is widely accepted as being the safest option in most circumstances, the use of regional anaesthesia increases the risk of patients experiencing intra-operative discomfort or pain. Pain during operative obstetric delivery is the commonest successful negligence claim relating to regional anaesthesia against obstetric anaesthetists in the UK. In the following article, using a database of over 360 cases spanning 21 years, we break down and examine the recurrent components of medicolegal claims concerning pain during caesarean section and consider how anaesthetists might avoid litigation...
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29097178/delayed-versus-early-umbilical-cord-clamping-for-preterm-infants-a-systematic-review-and-meta-analysis
#5
Michael Fogarty, David A Osborn, Lisa Askie, Anna Lene Seidler, Kylie Hunter, Kei Lui, John Simes, William Tarnow-Mordi
OBJECTIVE: To compare the effects of delayed versus early cord clamping on hospital mortality (primary outcome) and morbidity in preterm infants using Cochrane Collaboration Neonatal Review Group methodology. DATA SOURCES: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Chinese articles, cross-referencing citations, expert informants and trial registries to 31 July 2017. STUDY ELIGIBILITY: RCTs of delayed (≥ 30 seconds) vs early (<30 seconds) clamping in infants born <37 weeks gestation...
October 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25804214/defining-competence-in-obstetric-epidural-anaesthesia-for-inexperienced-trainees
#6
E J Drake, J Coghill, J R Sneyd
BACKGROUND: Cumulative sum (CUSUM) analysis has been used for assessing competence of trainees learning new technical skills. One of its disadvantages is the required definition of acceptable and unacceptable success rates. We therefore monitored the development of competence amongst trainees new to obstetric epidural anaesthesia in a large public hospital. METHODS: Obstetric epidural data were collected prospectively between January 1996 and December 2011. Success rates for inexperienced trainees were calculated retrospectively for (1) the whole database, (2) for each consecutive attempt and (3) each trainee's individual overall success rate...
June 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/24888772/hypertension-snoring-and-obstructive-sleep-apnoea-during-pregnancy-a-cohort-study
#7
L M O'Brien, A S Bullough, M C Chames, A V Shelgikar, R Armitage, C Guilleminualt, C E Sullivan, T R B Johnson, R D Chervin
OBJECTIVE: To assess the frequency of obstructive sleep apnoea among women with and without hypertensive disorders of pregnancy. DESIGN: Cohort study. SETTING: Obstetric clinics at an academic medical centre. POPULATION: Pregnant women with hypertensive disorders (chronic hypertension, gestational hypertension, or pre-eclampsia) and women who were normotensive. METHODS: Women completed a questionnaire about habitual snoring and underwent overnight ambulatory polysomnography...
December 2014: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/21873418/esc-guidelines-on-the-management-of-cardiovascular-diseases-during-pregnancy-the-task-force-on-the-management-of-cardiovascular-diseases-during-pregnancy-of-the-european-society-of-cardiology-esc
#8
Vera Regitz-Zagrosek, Carina Blomstrom Lundqvist, Claudio Borghi, Renata Cifkova, Rafael Ferreira, Jean-Michel Foidart, J Simon R Gibbs, Christa Gohlke-Baerwolf, Bulent Gorenek, Bernard Iung, Mike Kirby, Angela H E M Maas, Joao Morais, Petros Nihoyannopoulos, Petronella G Pieper, Patrizia Presbitero, Jolien W Roos-Hesselink, Maria Schaufelberger, Ute Seeland, Lucia Torracca
No abstract text is available yet for this article.
December 2011: European Heart Journal
https://www.readbyqxmd.com/read/28572227/medical-problems-in-pregnancy
#9
REVIEW
Bhaskar Narayan, Catherine Nelson-Piercy
The prevalence of medical problems in pregnancy is increasing because of a complex interplay between demographic and lifestyle factors, and developments in modern medicine. Maternal mortality and morbidity resulting from treatable medical conditions, such as venous thromboembolism, epilepsy and autoimmune disease, have not decreased in recent years. This is despite a marked decrease in overall maternal mortality. It is vital that all physicians acquire a basic knowledge and understanding of medical problems in pregnancy...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28980954/tranexamic-acid-for-post-partum-haemorrhage-in-the-woman-trial
#10
LETTER
Alicia Therese Dennis, James D Griffiths
No abstract text is available yet for this article.
September 30, 2017: Lancet
https://www.readbyqxmd.com/read/17848873/caffeine-for-the-prevention-and-treatment-of-postdural-puncture-headache-debunking-the-myth
#11
REVIEW
Rashmi B Halker, Bart M Demaerschalk, Kay E Wellik, Dean M Wingerchuk, Devon I Rubin, Brian A Crum, David W Dodick
OBJECTIVE: Is caffeine effective in preventing and treating postdural puncture headache (PDPH)? METHODS: The question was addressed with a structured evidence-based clinical neurologic practice review via videoconferencing between 3 academic institutions. Participants included consultant and resident neurologists, clinical epidemiologists, medical librarians, and clinical content experts. A critically appraised topic format was employed, starting with a clinical scenario and structured question...
September 2007: Neurologist
https://www.readbyqxmd.com/read/10928020/urgency-of-caesarean-section-a-new-classification
#12
MULTICENTER STUDY
D N Lucas, S M Yentis, S M Kinsella, A Holdcroft, A E May, M Wee, P N Robinson
A new classification for caesarean section was developed in a two-part study conducted at six hospitals. Initially, 90 anaesthetists and obstetricians graded ten clinical scenarios according to five different classification methods--visual analogue scale; suitable anaesthetic technique; maximum time to delivery; clinical definitions; and a 1-5 rating scale. Clinical definitions was the most consistent and useful, and this method was then applied prospectively to 407 caesarean sections at the same six hospitals...
July 2000: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/29046273/upright-versus-lying-down-position-in-second-stage-of-labour-in-nulliparous-women-with-low-dose-epidural-bumpes-randomised-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objective To determine whether being upright in the second stage of labour in nulliparous women with a low dose epidural increases the chance of spontaneous vaginal birth compared with lying down.Design Multicentre pragmatic individually randomised controlled trial.Setting 41 UK hospital labour wards.Participants 3093 nulliparous women aged 16 or older, at term with a singleton cephalic presentation and in the second stage of labour with epidural analgesia.Interventions Women were allocated to an upright or lying down position, using a secure web based randomisation service, stratified by centre, with no masking of participants or clinicians to the trial interventions...
October 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/17403403/postpartum-headache-is-your-work-up-complete
#14
Caroline L Stella, Cristiano D Jodicke, Helen Y How, Ursula F Harkness, Baha M Sibai
OBJECTIVE: Headache is a common finding in the postpartum period, and there are limited data describing the cause and treatment of women with postpartum headache. Our objective was to describe our experience with women who were hospitalized for postpartum headache and to develop a management algorithm for these women. STUDY DESIGN: Data for 95 women with headache >24 hours after delivery from 2000-2005 were reviewed retrospectively. Maternal assessment included an evaluation for benign and serious causes of headache that included preeclampsia, dural puncture, and neurologic lesions...
April 2007: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26043149/cardiac-complications-during-pregnancy-are-better-predicted-with-the-modified-who-risk-score
#15
A Pijuan-Domènech, L Galian, M Goya, M Casellas, C Merced, I Ferreira-Gonzalez, J R Marsal-Mora, L Dos-Subirà, M T Subirana-Domènech, V Pedrosa, F Baró-Marine, S Manrique, J Casaldàliga-Ferrer, P Tornos, L Cabero, D Garcia-Dorado
BACKGROUND/OBJECTIVE: Several risk scores (RSs) have been used to stratify risk of cardiac complications (CCs) in pregnant patients with heart disease. We aimed to compare and contrast the accuracy of several RSs for predicting CC in this population. METHODS: Prospective inclusion of all consecutive pregnant patients with heart disease, and follow-up until 6 months postpartum. CCs were defined as primary if admission was required due to heart failure, arrhythmia or thromboembolic events, and secondary if the decline in NYHA class compared with baseline was >2 or urgent invasive cardiac procedures were needed...
September 15, 2015: International Journal of Cardiology
https://www.readbyqxmd.com/read/29044483/hyperbaric-vs-isobaric-bupivacaine-for-spinal-anaesthesia-for-elective-caesarean-section-a-cochrane-systematic-review
#16
REVIEW
B L Sng, N L R Han, W L Leong, R Sultana, F J Siddiqui, P N Assam, E S Chan, K H Tan, A T Sia
Both isobaric and hyperbaric bupivacaine have been used for spinal anaesthesia for elective caesarean section, but it is not clear if one is better than the other. The primary objective of this systematic review was to determine the effectiveness and safety of hyperbaric bupivacaine compared with isobaric bupivacaine administered during spinal anaesthesia for elective caesarean section. We included 10 studies with 614 subjects in the analysis. There was no evidence of differences either in the risk of conversion to general anaesthesia, with a relative risk (95%CI) of 0...
October 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29016497/discontinuing-oxytocin-infusion-in-the-active-phase-of-labor-a-systematic-review-and-meta-analysis
#17
REVIEW
Gabriele Saccone, Andrea Ciardulli, Jason K Baxter, Joanne N Quiñones, Liany C Diven, Bor Pinar, Giuseppe Maria Maruotti, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To evaluate the benefits and harms of discontinuation of oxytocin after the active phase of labor is reached. DATA SOURCES: Electronic databases (ie, MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, ScienceDirect, the Cochrane Library at the CENTRAL Register of Controlled Trials, Scielo) were searched from their inception until April 2017. METHODS OF STUDY SELECTION: We included all randomized controlled trials comparing discontinuation (ie, intervention group) and continuation (ie, control group) of oxytocin infusion after the active phase of labor is reached, either after induction or augmentation of labor...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29016508/prophylactic-negative-pressure-wound-therapy-for-obese-women-after-cesarean-delivery-a-systematic-review-and-meta-analysis
#18
REVIEW
Marcela C Smid, Sarah K Dotters-Katz, Matthew Grace, Sarah T Wright, Margaret S Villers, Abbey Hardy-Fairbanks, David M Stamilio
OBJECTIVE: To summarize available studies on wound complication outcomes after prophylactic negative pressure wound therapy for obese women (body mass index 30 or greater). DATA SOURCES: We conducted a systematic review and meta-analysis using electronic database search (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Google scholar, and Web of Science), Cochrane, and trial registries including ClinicalTrials.gov. METHODS OF STUDY SELECTION: We conducted an electronic search of research articles from 1966 to January 2017 for randomized controlled trials (RCTs), prospective cohort, and retrospective cohort studies of negative pressure wound therapy compared with standard dressing after cesarean delivery among obese women...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29016499/epidural-analgesia-during-the-second-stage-of-labor-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
XiaoFeng Shen, Yunping Li, ShiQin Xu, Nan Wang, Sheng Fan, Xiang Qin, Chunxiu Zhou, Philip E Hess
OBJECTIVE: To evaluate whether maintaining a motor-sparing epidural analgesia infusion affects the duration of the second stage of labor in nulliparous parturients compared with a placebo control. METHODS: We conducted a double-blind, randomized, placebo-controlled trial involving nulliparous women with term cephalic singleton pregnancies who requested epidural analgesia. All women received epidural analgesia for the first stage of labor using 0.08% ropivacaine with 0...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28885411/improvement-in-outcomes-of-major-obstetric-hemorrhage-through-systematic-change
#20
Daniel W Skupski, David Brady, Isaac P Lowenwirt, Jason Sample, Stephanie N Lin, Rahul Lohana, Gary S Eglinton
OBJECTIVE: To report the outcomes over 14 years of sustained systematic institutional focus on the care of women with major obstetric hemorrhage, defined as estimated blood loss greater than 1,500 mL. METHODS: A retrospective cohort study of women with major obstetric hemorrhage at our hospital from 2000 to 2014 compares baseline conditions (age, multiparity, prior cesarean delivery, morbidly adherent placenta), morbidity (lowest mean temperature, lowest mean pH, coagulopathy, hysterectomy), and mortality among three time periods (period 1=January 2000 to December 2001, period 2=January 2002 to August 2005, period 3=September 2005 to December 2014)...
October 2017: Obstetrics and Gynecology
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