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Obs and Gynae

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14 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27555797/current-best-practice-in-the-management-of-hypertensive-disorders-in-pregnancy
#1
REVIEW
Rosemary Townsend, Patrick O'Brien, Asma Khalil
Preeclampsia is a potentially serious complication of pregnancy with increasing significance worldwide. Preeclampsia is the cause of 9%-26% of global maternal mortality and a significant proportion of preterm delivery, and maternal and neonatal morbidity. Incidence is increasing in keeping with the increase in obesity, maternal age, and women with medical comorbidities entering pregnancy. Recent developments in the understanding of the pathophysiology of preeclampsia have opened new avenues for prevention, screening, and management of this condition...
2016: Integrated Blood Pressure Control
https://www.readbyqxmd.com/read/27655279/a-survey-of-intravenous-remifentanil-use-for-labor-analgesia-at-academic-medical-centers-in-the-united-states
#2
Jaime Aaronson, Sharon Abramovitz, Richard Smiley, Virginia Tangel, Ruth Landau
Remifentanil is most commonly offered when neuraxial labor analgesia is contraindicated. There is no consensus regarding the optimal administration, dosing strategy, or requirements for maternal monitoring, which may pose a patient safety issue. This exploratory survey evaluated the current practices regarding remifentanil use for labor analgesia at academic centers in the United States. Of 126 obstetric anesthesia directors surveyed, 84 (67%) responded. In 2014 to 2015, an estimated 36% (95% confidence interval: 25...
September 20, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27619509/remifentanil-for-labor-analgesia-a-comprehensive-review
#3
Yayoi Ohashi, Leyla Baghirzada, Hiroyuki Sumikura, Mrinalini Balki
Japan has seen significant developments in obstetric anesthesia in recent years, including the establishment of the Japanese Society of Obstetric Anesthesia and Perinatology. However, labor pain, which is one of the most important issues in obstetric practice, is still not treated aggressively. The rate of epidural administration for labor analgesia is very low in Japan as compared to other developed countries. Remifentanil has been used for labor analgesia, as part of general anesthesia for cesarean delivery, as well as for various fetal procedures around the world...
September 12, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27607089/amniotic-fluid-embolism-after-intrauterine-fetal-demise
#4
Karl Kristensen, Fali Langdana, Howard Clentworth, Chu Hansby, Paul Dalley
We present a case of the successful treatment of severe amniotic fluid embolism in a 41-year-old woman undergoing emergency caesarean section at 36 weeks of gestation for placental abruption and intrauterine fetal demise. The treatment included prolonged cardiopulmonary resuscitation, emergency hysterectomy, re-operation with intra-abdominal packing and intra-aortic balloon pump insertion. The patient made a remarkable recovery and to date has minimal residual morbidity. Amniotic fluid embolism syndrome (AFES) is a rare and often fatal obstetric condition that remains one of the main causes of maternal mortality in developed countries...
2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27608347/anaesthetists-experiences-with-the-early-labour-epidural-recommendation-for-obese-parturients-a-qualitative-study
#5
V A Eley, L K Callaway, A A J van Zundert, J Lipman, C Gallois
Caring for obese pregnant women presents challenges for all medical professionals. Despite a lack of supporting evidence, expert opinion and international guidelines suggest early labour epidural insertion for obese women. Anecdotally this is not supported by all anaesthetists. This qualitative study explored the experiences of anaesthetists regarding early epidural analgesia in obese parturients, to answer the research question: Are anaesthetists consistent in how they apply early epidural analgesia in obese parturients? Personal in-depth interviews with 42 specialist anaesthetists working in south-east Queensland, Australia, were completed between February and April, 2015...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27612214/outcomes-of-pelvic-arterial-embolization-in-the-management-of-postpartum-haemorrhage-a-case-series-study-and-systematic-review
#6
F J Ruiz Labarta, M P Pintado Recarte, A Alvarez Luque, L Joigneau Prieto, L Perez Martín, M Gonzalez Leyte, F Palacio Abizanda, F Morillas Ramirez, A Perez Corral, L Ortiz Quintana, J De Leon-Luis
BACKGROUND: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Pelvic arterial embolization (PAE) is considered as a second-line treatment, although the published results have not been reviewed systematically since 2007. OBJECTIVES: To evaluate success and complication rates of PAE to treat PPH in the study hospital between 2009 and 2015, and to perform a systematic review of the literature on the reported efficacy and safety of PAE for the management of PPH...
August 4, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27580408/cerebrospinal-fluid-cutaneous-fistula-after-continuous-spinal-catheter-in-an-obstetric-patient
#7
Mark J Lenart, Jeffrey M Carness
A 23-year-old woman at 41 weeks and 6 days estimated gestational age underwent continuous spinal analgesia for labor after a recognized, unintended dural puncture. Excellent analgesia was maintained throughout labor and vaginal delivery, the intrathecal catheter was left in situ for 24 hours postpartum, and the catheter was subsequently removed without apparent complication. On physical examination during her anesthesia postoperative visit, clear fluid was noted to be slowly draining from the catheter insertion site...
September 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27591352/diabetes-in-pregnancy
#8
Howard Berger, Robert Gagnon, Mathew Sermer, Melanie Basso, Hayley Bos, Richard N Brown, Emmanuel Bujold, Stephanie L Cooper, Robert Gagnon, Katy Gouin, N Lynne McLeod, Savas M Menticoglou, William R Mundle, Anne Roggensack, Frank L Sanderson, Jennifer D Walsh
OBJECTIVE: This guideline reviews the evidence relating to the diagnosis and obstetrical management of diabetes in pregnancy. OUTCOMES: The outcomes evaluated were short- and long-term maternal outcomes, including preeclampsia, Caesarean section, future diabetes, and other cardiovascular complications, and fetal outcomes, including congenital anomalies, stillbirth, macrosomia, birth trauma, hypoglycemia, and long-term effects. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library using appropriate controlled vocabulary (MeSH terms "diabetes" and "pregnancy")...
July 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/22551110/diagnosis-and-management-of-maternal-thrombocytopenia-in-pregnancy
#9
REVIEW
Bethan Myers
Thrombocytopenia is a common finding in pregnancy, occurring in approximately 7-10% of pregnancies. It may be a diagnostic and management problem, and has many causes, some of which are specific to pregnancy. Although most cases of thrombocytopenia in pregnancy are mild, and have no adverse outcome for either mother or baby, occasionally a low platelet count may be part of a more complex disorder with significant morbidity and may be life-threatening. Overall, about 75% of cases are due to gestational thrombocytopenia, 15-20% secondary to hypertensive disorders; 3-4% due to an immune process, and the remaining 1-2% made up of rare constitutional thrombocytopenias, infections and malignancies...
July 2012: British Journal of Haematology
https://www.readbyqxmd.com/read/27546871/update-on-the-management-of-thyroid-disease-during-pregnancy
#10
REVIEW
Chang Hoon Yim
Thyroid dysfunction during pregnancy can result in serious complications for both the mother and infant; however, these complications can be prevented by optimal treatment of maternal overt thyroid dysfunction. Although several studies have demonstrated that maternal subclinical hypothyroidism is associated with obstetric complications and neurocognitive impairments in offspring, there is limited evidence that levothyroxine treatment can improve these complications. Therefore, most professional societies do not recommend universal screening for thyroid dysfunction during pregnancy, and instead recommend a case-finding approach in which only high-risk women are tested...
September 2016: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27512937/subdural-hematoma-associated-with-labor-epidural-analgesia-a-case-series
#11
Grace Lim, Jamie M Zorn, Yuanxu J Dong, Joseph S DeRenzo, Jonathan H Waters
OBJECTIVE: This report aimed to describe the characteristics and impact of subdural hematoma (SDH) after labor epidural analgesia. CASE REPORTS: Eleven obstetric patients had SDHs associated with the use of labor epidural analgesia over 7 years at a tertiary care hospital. Ten of 11 patients had signs consistent with postdural puncture headache before the diagnosis of SDH. Five patients (45%) had a recognized unintentional dural puncture, 1 (9%) had a combined spinal-epidural with a 24-gauge needle, and 5 (45%) had no recognized dural puncture...
September 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27509225/the-effect-of-combined-spinal-epidural-versus-epidural-analgesia-in-laboring-women-on-nonreassuring-fetal-heart-rate-tracings-systematic-review-and-meta-analysis
#12
Judith Hattler, Markus Klimek, Rolf Rossaint, Michael Heesen
BACKGROUND: Combined spinal-epidural labor analgesia has gained popularity, but it is unclear whether this technique is associated with a higher incidence of nonreassuring fetal heart rate (FHR) tracings compared with epidural analgesia. Our meta-analysis aimed at comparing the incidence of nonreassuring FHR tracings between the 2 neuraxial techniques. METHODS: Databases were searched to identify randomized controlled trials that compared the incidence of nonreassuring FHR tracings, as defined in the individual studies, after combined spinal-epidural versus epidural analgesia in laboring women...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27038069/through-a-glass-darkly-ultrasound-imaging-in-obstetric-anaesthesia
#13
EDITORIAL
D N Lucas, C D Elton
No abstract text is available yet for this article.
June 2016: Anaesthesia
https://www.readbyqxmd.com/read/27474801/reproductive-aspects-of-systemic-lupus-erythematosus
#14
REVIEW
Ozgur Oktem, Hande Yagmur, Hale Bengisu, Bulent Urman
Systemic lupus erythematosus (SLE) is an auto-immune systemic disease showing a strong predilection for women of reproductive age. Higher prevalance of SLE among young women are in part accounted for by the effects of estrogen hormone on immune system. The key pathophysiological features of this disease are the generation of autoantibodies and the deposition of antibody-antigen complexes in the basal membranes of the organs where they evoke inflammatory responses and injury. Young females diagnosed with SLE are more prone to developing a multitude of adverse reproductive and obstetric outcomes, especially in the presence of active disease...
September 2016: Journal of Reproductive Immunology
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