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Obstetric Anesthesia

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131 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/28504988/the-labor-analgesia-requirements-in-nulliparous-women-randomized-to-epidural-catheter-placement-in-a-high-or-low-intervertebral-space
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28474356/patients-preferences-for-labor-analgesic-counseling-a-qualitative-analysis
#4
Paloma Toledo, Javiera Pumarino, William A Grobman, Cynthia A Wong, Jane L Holl, Romana Hasnain-Wynia
BACKGROUND: The decision to use, or not use, neuraxial labor analgesia is complex, with both maternal and fetal considerations. Fears and concerns about neuraxial analgesia may influence analgesic decision-making. Little is known about patients' preferences for analgesic counseling. Therefore, the objectives of this qualitative study were to evaluate the sources of information used by patients, the timing and content of antepartum counseling about labor analgesia, and patients' preferences for such counseling...
May 5, 2017: Birth
https://www.readbyqxmd.com/read/28445702/an-early-history-of-anesthesia-in-labor
#5
Mary E Gibson
Fear of pain often overshadows childbirth, and each woman must decide whether to receive anesthesia to combat labor pain. Historically, this choice resulted in unintended consequences and marked the beginnings of medical interventions in labor and birth. The purpose of this article is to trace the use of anesthesia in childbirth from the mid-19th to the mid-20th centuries and to explore its influence on childbearing women and nurses.
April 23, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#6
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28351670/preemptive-analgesia-for-postoperative-hysterectomy-pain-control-systematic-review-and-clinical-practice-guidelines
#7
REVIEW
Adam C Steinberg, Megan O Schimpf, Amanda B White, Cara Mathews, David R Ellington, Peter Jeppson, Catrina Crisp, Sarit O Aschkenazi, Mamta M Mamik, Ethan M Balk, Miles Murphy
OBJECTIVE: The objective of the study was to investigate the effectiveness of preemptive analgesia at pain control in women undergoing total abdominal hysterectomy. DATA SOURCES: Eligible studies, published through May 31, 2016, were retrieved through Medline, Cochrane Central Register for Controlled Trials, and Cochrane Database of Systematic Reviews. STUDY ELIGIBILITY: We included randomized controlled trials with the primary outcome of pain control in women receiving a preemptive medication prior to total abdominal hysterectomy...
March 27, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28323669/quality-maternal-care-a-call-for-anesthesia-leadership-and-collaboration
#8
Jeanette R Bauchat
No abstract text is available yet for this article.
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28303340/the-influence-of-the-systematic-birth-preparation-program-on-childbirth-satisfaction
#9
Aysu Akca, Aytul Corbacioglu Esmer, Eser Sefik Ozyurek, Arife Aydin, Nazli Korkmaz, Husnu Gorgen, Ozgur Akbayir
PURPOSE: The primary purpose of this study was to assess the influence of a systematic multidisciplinary birth preparation program on satisfaction with childbirth experience. A secondary aim was to detect factors that affect the childbirth satisfaction. METHODS: In this prospective study, 77 pregnant women who completed the 4-month birth preparation program (Group 1) and 75 women in the control group (Group 2) were asked to fill out two questionnaires with face-to-face interviews within 48 h after labor...
March 16, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28286001/understanding-high-utilization-of-unscheduled-care-in-pregnant-women-of-low-socioeconomic-status
#10
Pooja K Mehta, Tamala Carter, Cjloe Vinoya, Shreya Kangovi, Sindhu K Srinivas
BACKGROUND: Pregnant high utilizers of unscheduled care may be at particular risk for poor perinatal outcomes, but the drivers of this association have not been explored from the patient perspective. PURPOSE: We sought to understand maternal preference for unscheduled hospital-based obstetric care to inform interventions and improve value of publicly funded care during pregnancy. METHODS: We conducted a comparative qualitative analysis of in-depth semistructured interviews...
March 9, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28284877/midwifery-continuity-of-carer-in-an-area-of-high-socio-economic-disadvantage-in-london-a-retrospective-analysis-of-albany-midwifery-practice-outcomes-using-routine-data-1997-2009
#11
Caroline Se Homer, Nicky Leap, Nadine Edwards, Jane Sandall
OBJECTIVE: in 1997, The Albany Midwifery Practice was established within King's College Hospital NHS Trust in a South East London area of high social disadvantage. The Albany midwives provided continuity of care to around 216 women per year, including those with obstetric, medical or social risk factors. In 2009, the Albany Midwifery Practice was closed in response to concerns about safety, amidst much publicity and controversy. The aim of this evaluation was to examine trends and outcomes for all mothers and babies who received care from the practice from 1997-2009...
February 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28277399/best-practices-in-management-of-postpartum-pain
#12
Jenifer O Fahey
Pain has been documented as a major concern for women in the postpartum period. Management of postpartum pain, however, is a relatively neglected area of clinical research. As a result, evidence to support interventions to alleviate the discomforts associated with childbirth is sparse. This paucity of research on postpartum pain management is particularly surprising given that in the United States alone nearly 4 million women give birth each year. Inadequate pain relief in the hours to months following childbirth can interfere with maternal-newborn bonding and feeding and, by impeding mobility, can increase the risk of postpartum complications...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28277382/current-applications-of-big-data-in-obstetric-anesthesiology
#13
Thomas T Klumpner, Melissa E Bauer, Sachin Kheterpal
PURPOSE OF REVIEW: The narrative review aims to highlight several recently published 'big data' studies pertinent to the field of obstetric anesthesiology. RECENT FINDINGS: Big data has been used to study rare outcomes, to identify trends within the healthcare system, to identify variations in practice patterns, and to highlight potential inequalities in obstetric anesthesia care. Big data studies have helped define the risk of rare complications of obstetric anesthesia, such as the risk of neuraxial hematoma in thrombocytopenic parturients...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28235511/increasing-body-mass-index-predicts-increasing-difficulty-failure-rate-and-time-to-discovery-of-failure-of-epidural-anesthesia-in-laboring-patients
#14
Ayse O Kula, Matthias L Riess, Elizabeth H Ellinas
STUDY OBJECTIVE: Obese parturients both greatly benefit from neuraxial techniques, and may represent a technical challenge to obstetric anesthesiologists. Several studies address the topic of obesity and neuraxial analgesia in general, but few offer well described definitions or rates of "difficulty" and "failure" of labor epidural analgesia. Providing those definitions, we hypothesized that increasing body mass index (BMI) is associated with negative outcomes in both categories and increased time needed for epidural placement...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27406639/complementary-therapies-for-labour-and-birth-study-a-randomised-controlled-trial-of-antenatal-integrative-medicine-for-pain-management-in-labour
#15
Kate M Levett, C A Smith, A Bensoussan, H G Dahlen
OBJECTIVE: To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. DESIGN: Open-label, assessor blind, randomised controlled trial. SETTING: 2 public hospitals in Sydney, Australia. POPULATION: 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. METHODS AND INTERVENTION: The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support...
July 12, 2016: BMJ Open
https://www.readbyqxmd.com/read/28221178/non-neuraxial-labor-analgesia-options
#16
John C Markley, Mark D Rollins
Although it is the most effective method to treat labor pain, neuraxial analgesia may be undesired, contraindicated, unsuccessful, or unavailable. Providing safe choices for labor pain relief is a central goal of health care providers alike. Consequently, knowledge of the efficacy, clinical implementation, and side effects of various non-neuraxial strategies is needed to provide appropriate options for laboring patients. In addition to nonpharmacologic alternatives, inhaled nitrous oxide and systemic opioids represent two broad classes of non-neuraxial pharmacologic labor analgesia most commonly available...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28202311/anesthetic-considerations-for-labor-and-delivery-in-women-with-cerebrospinal-fluid-shunts
#17
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...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28124390/how-do-pregnant-women-use-quality-measures-when-choosing-their-obstetric-provider
#18
Rebecca A Gourevitch, Ateev Mehrotra, Grace Galvin, Melinda Karp, Avery Plough, Neel T Shah
BACKGROUND: Given increased public reporting of the wide variation in hospital obstetric quality, we sought to understand how women incorporate quality measures into their selection of an obstetric hospital. METHODS: We surveyed 6141 women through Ovia Pregnancy, an application used by women to track their pregnancy. We used t tests and chi-square tests to compare response patterns by age, parity, and risk status. RESULTS: Most respondents (73...
January 26, 2017: Birth
https://www.readbyqxmd.com/read/28131113/epidural-analgesia-for-labor-continuous-infusion-versus-programmed-intermittent-bolus
#19
REVIEW
Onyi C Onuoha
Despite the traditional practice to maintain labor analgesia with a combination of continuous epidural infusion and patient-controlled epidural analgesia using an automated epidural pump; compelling data now shows that bolus injection through the epidural catheter may result in better distribution of anesthetic solution in the epidural space. The programmed intermittent epidural bolus technique is proposed as a better maintenance mode and may represent a more effective mode of maintaining epidural analgesia for labor, especially prolonged labor...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28079587/review-of-the-alternatives-to-epidural-blood-patch-for-treatment-of-postdural-puncture-headache-in-the-parturient
#20
Daniel Katz, Yaakov Beilin
Labor neuraxial anesthesia is commonly used in the parturient, and postdural puncture headache is the most common complication of the technique. Although epidural blood patch is the best treatment, there are some patients in whom this treatment is refused or contraindicated. The goal of this article is to review the efficacy of the most studied alternate modalities to treat postdural puncture headache. This will include a discussion of the various oral or intravenous therapies and the non-blood-containing epidural injections...
April 2017: Anesthesia and Analgesia
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