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Pregnancy and anesthesia

S Devroe, T Bleeser, M Van de Velde, L Verbrugge, F De Buck, J Deprest, R Devlieger, S Rex
INTRODUCTION: This retrospective, matched case-control cohort study describes the incidence, indications, anesthesia techniques and outcomes of pregnancies complicated by surgery in a single tertiary-referral hospital. METHODS: Retrospective review of the hospital records of 171 patients who had non-obstetric surgery in the current pregnancy, between 2001 and 2016. Pregnancy outcomes of these women were firstly compared with all contemporary non-exposed patients (n=35 411), and secondly with 684 non-exposed control patients, matched for age, time of delivery and parity...
January 12, 2019: International Journal of Obstetric Anesthesia
Piya Chaemsaithong, Angel H W Kwan, Wing Ting Tse, Wen Teng Lim, Winnie W Y Chan, Ka Chun Chong, Tak Yeung Leung, Liona C Poon
BACKGROUND: The traditional approach to assessing labor progress is by digital vaginal examination, however, it is subjective and imprecise. Recent studies have investigated the role of transperineal ultrasonographic assessment of fetal head descent by measuring angle of progression and head-perineum distance. OBJECTIVE: The objective of this study was to evaluate factors that affected labor progress, defined by the transperineal ultrasonographic parameters, in women achieving vaginal delivery...
February 5, 2019: American Journal of Obstetrics and Gynecology
Safinaz Abdelrahman, Nooraldaem Yousif
BACKGROUND: Mitral stenosis is one of the most commonly encountered valvular heart diseases during pregnancy, the majority are rheumatic in origin and poorly tolerated due to cardio circulatory changes that occur during pregnancy, labor and postpartum. OBJECTIVE: The distinctive physiological events that arise during pregnancy and labor and the influence of mitral stenosis are tackled in this article. METHOD: Through PUBMED and MEDLINE searches, we reviewed the literature of the last decade as well as the recommendations from guidelines of high-impact worldwide...
February 7, 2019: Reviews on Recent Clinical Trials
Sanaa Kamal, Sara Abdelhakam, Dalia Ghoraba, Yasmin Massoud, Kareem Abdel Aziz, Huda Hassan, Tamer Hafez, Ahmed Abdel Sallam
BACKGROUND: Gilbert syndrome (GS) is an autosomal recessive inherited disorder of bilirubin glucuronidation which has not been investigated in Egypt. This longitudinal study investigated the frequency, clinical course, genetic profile and health related quality of life in Egyptian adults. METHODS: An initial cross-sectional study was conducted to assess the frequency of Gilbert syndrome among Egyptian adults. Subjects fulfilling the criteria of GS were enrolled into the study and prospectively followed for the clinical features, risk factors for hyperbilirubinemia, health related quality of life [Short form-36 Health Survey version 2 (SF-36v2) and Chronic Liver Disease Questionnaire (CLDQ)], vitamins assessment and UGT1A1 polymorphisms...
February 4, 2019: BMC Gastroenterology
Dan G Halpern, Catherine R Weinberg, Rebecca Pinnelas, Shilpi Mehta-Lee, Katherine E Economy, Anne Marie Valente
Cardiovascular disease complicating pregnancy is rising in prevalence secondary to advanced maternal age, cardiovascular risk factors, and the successful management of congenital heart disease conditions. The physiological changes of pregnancy may alter drug properties affecting both mother and fetus. Familiarity with both physiological and pharmacological attributes is key for the successful management of pregnant women with cardiac disease. This review summarizes the published data, available guidelines, and recommendations for use of cardiovascular medications during pregnancy...
February 5, 2019: Journal of the American College of Cardiology
Caitlin Dooley Sutton, Brendan Carvalho
We describe the management of a pregnant patient with osteogenesis imperfecta with a history of numerous fractures, severe scoliosis, and anticipated difficult airway. Her pregnancy was complicated by progressive shortness of breath and a fetal diagnosis of osteogenesis imperfecta. Spine anatomy precluded neuraxial anesthesia. Cesarean delivery was performed under general anesthesia at 34 weeks. Immediately after awake fiberoptic intubation and induction of general anesthesia, capnography waveform was lost with rapid profound oxygen desaturation...
January 28, 2019: A&A practice
Mahmut Alp Karahan, Adnan Incebiyik, Evren Buyukfirat, Nuray Altay, Orhan Binici, Feyzullah Besli
OBJECTIVES: In this study, we aimed to investigate the effects of spinal anesthesia on the QT interval in patients with term and post-term pregnancy that were scheduled for elective cesarean section. MATERIALS AND METHODS: Forty pregnant women scheduled for elective cesarean section under spinal anesthesia were assigned into two groups: Post-term group (Group P) (n = 20) and Term group (Group T) (n = 20). After entering the operation room, standard monitoring [electrocardiography (ECG), noninvasive blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation] was performed...
January 27, 2019: Journal of Maternal-fetal & Neonatal Medicine
Renata P B Carneiro, Gustavo G Macedo, Rafael DeRossi, Eliane V Costa-E-Silva, Maria Inês L Souza
This study aimed to evaluate the impact of subarachnoid anesthesia with ketamine during transcervical artificial insemination (TCAI) on the welfare of ewes and on subsequent pregnancy rates. Ninety Suffolk adult ewes were randomized into three treatment groups: control group (CG), which underwent the TCAI procedure as established by cervical traction (CG; n = 30) and two groups that received subarachnoid anesthesia with ketamine at a dose of either 0.75 mg/kg (KE0.75; n = 30) or 1.5 mg/kg (KE1.5; n = 30) 5 min before the cervical traction procedure...
January 26, 2019: Tropical Animal Health and Production
Xing Ran, Ming Yu
PURPOSE: This study was conducted to evaluate the knowledge of family physicians regarding oral disease treatment during pregnancy in Jiading district, Shanghai city. METHODS: A questionnaire was designed, involving the knowledge of oral health care and oral disease treatment during pregnancy. Data retrieved was entered into Excel database and analyzed using SPSS20.0 software package. RESULTS: 203 family physicians were involved in the investigation...
October 2018: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
Tamina Kino, Yuriko Yamamoto, Yusuke Saigusa, Shigeru Aoki, Etsuko Miyagi
OBJECTIVE: Cesarean delivery at a preterm gestational age has been related to maternal complications such as bleeding and infection. However, previous reports are conflicting, and there is no consensus on the matter. We aimed to clarify the adverse effect of preterm cesarean delivery with an emphasis on maternal bleeding. STUDY DESIGN: We conducted a retrospective study comparing the frequency of maternal adverse outcome between preterm emergency cesarean delivery and term emergency cesarean delivery...
January 9, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Divya Gupta, Gurjeet Khurana, Parul Jindal, Pradeep Aggarwal
Context: Exposure to medications (prescribed or over-the-counter) or exposure to chemicals (unintentional or occupational) during pregnancy have always been of great scientific concerns. Aims: This study aims to ascertain whether the recently documented offspring sex ratio (OSR) skew in medical literature is reproducible among our respondent population and how our respondents' characteristics relate to the OSR skew (if any) in our respondent population. Settings and Design: A survey questionnaire uploaded on the SurveyMonkey® Online Portal...
October 2018: Anesthesia, Essays and Researches
Gennadiy A Katsevman, Ryan C Turner, Cletus Cheyuo, Charles L Rosen, Matthew S Smith
Posterior reversible encephalopathy syndrome (PRES) is an uncommon but potentially devastating syndrome if not recognized and treated appropriately. As the name implies, recognition of the condition and proper management may reverse the clinical and radiological findings. However, diagnosis is not always straightforward. We present the case of a 24-year-old female who was 4 days post-partum and presented with headache, neck pain, and new-onset seizures. She had undergone epidural anesthesia during labor, and initial imaging was suggestive of intracranial hypotension versus pachymeningitis...
January 18, 2019: Acta Neurochirurgica
Jiachen Tang, Rachel Fullarton, Sheri-Lee Samson, Yu Chen
BACKGROUND: Although delayed umbilical cord clamping has been shown to have significant benefits for both term and preterm infants, currently, data on its impact on blood gas analysis have been scant and conflicting. METHODS: In a retrospective review, we compared the demographic characteristics and blood gas parameters of 114 delayed cord clamping (DCC-births between 45 and 90 s in length; 109 being for 60 s) versus 407 early cord clamping births (ECC-immediately after delivery) collected over a 1-year period...
January 17, 2019: Archives of Gynecology and Obstetrics
Kelsey North, Ana Tobiasz, Ryan D Sullivan, Zoran Bursac, Jose Duncan, J Pierce Sullivan, Steven Davison, Danielle L Tate, Stacey Barnett, Giancarlo Mari, Anna N Bukiya
Approximately half of pregnant women engage in alcohol consumption some time during pregnancy. On the other hand, a small percentage of pregnant women undergo surgery and anesthesia at some time during pregnancy. In emergencies, anesthesia has to be administered to patients who are under alcohol intoxication. Anesthetic management during pregnancy while patients are intoxicated with alcohol is challenging. Here, we utilized a retrospective analysis of data available from 17 pregnant baboons that underwent anesthesia with alcohol exposure during mid-pregnancy...
June 2018: Journal of Drug and Alcohol Research
Wen Xu, C Tyler Smith, Anna Binstock, Grace Lim
Mirror syndrome is a rare pregnancy complication, life-threatening to mother and fetus. Increasing survival rates of congenital heart disease into reproductive age mean that complications like Mirror syndrome in this population may be more challenging to diagnose, given overlapping signs of edema in cases of heart failure exacerbation. We report a case of a pregnant woman with a history of unspecified congenital heart disease, presenting with swelling and distension, with diagnostic findings not consistent with preeclampsia...
January 10, 2019: A&A practice
Dan Huang, Linjie Zhu, Jie Chen, Jie Zhou
BACKGROUND: Anticoagulant therapy during pregnancy is widely used due to the increasing awareness of maternal hypercoagulability. Few studies have reported the use of minimally invasive spinal anesthesia in these parturients. The objective of this study was to evaluate the safety and feasibility of minimally invasive spinal anesthesia in parturients with anticoagulation therapy undergoing cesarean section. METHODS: This was a randomized, controlled study conducted in 239 parturients using anticoagulants and undergoing selective cesarean section...
January 12, 2019: BMC Anesthesiology
Ana M Palacios-Marqués, Concepción Carratala-Munuera, Juan C Martínez-Escoriza, Vicente F Gil-Guillen, Adriana Lopez-Pineda, Jose A Quesada, Domingo Orozco-Beltrán
BACKGROUND: Randomised clinical trials are considered to be the most reliable study design for assessing the efficacy and safety of health interventions. AIMS: To analyse worldwide obstetrics research carried out through randomised clinical trials, from 2002 to 2013. METHODS: A bibliometric analysis was performed. Publications on obstetrics that were published journals indexed in the MEDLINE database from 2002 to 2013 were analysed. The major medical subject headings used in the search were obstetrics, pregnancy complications and obstetrics surgical procedures...
January 9, 2019: Irish Journal of Medical Science
Yaniv Zipori, Oren Grunwald, Yuval Ginsberg, Ron Beloosesky, Zeev Weiner
BACKGROUND: A low rate of primary cesarean delivery is expected to reduce some of the major complications that are associated with a repeat cesarean delivery such as uterine rupture, adhesive placental disorders, hysterectomy and even maternal death. Since 2014, and in alignment with the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, we changed our approach to labor dystocia, defined as abnormal progression of labor, by allowing a longer duration of the second stage of labor...
October 25, 2018: American Journal of Obstetrics and Gynecology
Edgardo Corral, Waldo Sepulveda, Franco Ravera, Jose M Muller, Mirta Tapia, Mauricio Reascos, Gonzalo Perez-Canto
OBJECTIVE: To describe the use of a selfretaining thermoplastic polyurethane wound retractor for the management of hysterotomy during prenatal repair of myelomeningocele. METHODS: The preliminary experience with 16 consecutive cases of open surgery for prenatal repair of myelomeningocele using a new technique is presented. Under general anesthesia, the gravid uterus was partially exteriorized through a low transverse abdominal incision and a high 3-4-cm midline vertical minihysterotomy was performed...
January 7, 2019: Journal of Maternal-fetal & Neonatal Medicine
Yuki Hosokawa, Toshiyuki Okutomi, Shunsuke Hyuga, Rie Kato, Krzysztof M Kuczkowski
BACKGROUND: The accurate identification of an intervertebral lumbar level is essential to avoid neuraxial anesthesia and analgesia-related spinal cord injury. It has been shown that estimation of L3/4 intervertebral lumbar level based on the intercristal line determined by palpation (palpated L3/4) is often inaccurate. However; studies evaluating intervertebral lumbar level concordance based on palpation vs. ultrasonography were conducted in Western populations (i.e. in North America and/or Europe)...
January 6, 2019: Journal of Maternal-fetal & Neonatal Medicine
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