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M-P Bonnet, A Tesnière, A Mignon
Post-partum haemorrhage is the first cause of maternal death in France. In addition to the treatment of the cause, its treatment consists in the association of procoagulant drugs and blood transfusion. At risk situations requiring blood transfusion are well identified. However, they are not found in one third of the actually transfused patients. Therefore, for all deliveries, the medical team should be prepared to face a post-partum haemorrhage and to transfuse. As post-partum haemorrhage onset is most frequently acute, it is rare to be able to base the transfusion decision on biological parameters such as haemoglobin concentration and / or coagulation tests...
April 2011: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Roland Csorba
Primary post partum haemorrhage is the most common form of major obstetric haemorrhage. The traditional definition of primary post partum haemorrhage is the loss of 500 ml or more of blood from the genital tract within 24 hours of the birth of a baby. Post partum haemorrhage can be minor (500-1000 ml) or major (more than 1000 ml). Major could be divided to moderate (1000-2000 ml) or severe (more than 2000 ml). The recommendations in this article apply to women experiencing primary post partum haemorrhage of 500 ml or more...
April 29, 2012: Orvosi Hetilap
Mariana Widmer, Jennifer Blum, G Justus Hofmeyr, Guillermo Carroli, Hany Abdel-Aleem, Pisake Lumbiganon, Thi Nhu Ngoc Nguyen, Daniel Wojdyla, Jadsada Thinkhamrop, Mandisa Singata, Luciano E Mignini, Mahmoud Ahmad Abdel-Aleem, Son Thach Tran, Beverly Winikoff
BACKGROUND: Post-partum haemorrhage is a leading cause of global maternal morbidity and mortality. Misoprostol, a prostaglandin analogue with uterotonic activity, is an attractive option for treatment because it is stable, active orally, and inexpensive. We aimed to assess the effectiveness of misoprostol as an adjunct to standard uterotonics compared with standard uterotonics alone for treatment of post-partum haemorrhage. METHODS: Women delivering vaginally who had clinically diagnosed post-partum haemorrhage due to uterine atony were enrolled from participating hospitals in Argentina, Egypt, South Africa, Thailand, and Vietnam between July, 2005, and August, 2008...
May 22, 2010: Lancet
Manuela Bezerril Cipião Fernandes, Rodrigo Vicentini Fernandes de Souza, Gregório Carolino Vasconcelos, Kérsia Gomes Ribeiro, Bruno Bezerril Andrade, Cláudia Regina Fernandes
PURPOSE: Ocular akinesia, the use of anticoagulants, and patient collaboration are some of the factors that must be taken into consideration when choosing the appropriate anesthesia for phacoemulsification cataract surgery. The satisfaction of patients with the use of topical anesthesia and conscious sedation for this procedure has not been enough described in Brazil. Conscious sedation allows patient walk and answer a voice command. To assess the satisfaction, pain, and perioperative hemodynamic alterations of patients subjected to phacoemulsification under conscious sedation and topical anesthesia supplemented with intracameral lidocaine...
November 2013: Arquivos Brasileiros de Oftalmologia
Claudia Chi, Christine A Lee, Adrian England, Jaishree Hingorani, James Paintsil, Rezan A Kadir
A retrospective review was carried out on the methods of obstetric analgesia/anesthesia used in 80 pregnancies amongst 63 women with inherited bleeding disorders (19 factor XI deficiency, 16 carriers of haemophilia, 15 von Willebrand disease, seven platelet function disorders, four factor VII deficiency, one factor VII and XI deficiency and one factor X deficiency). In 72 pregnancies, the woman was seen antenatally in a multidisciplinary clinic to discuss and plan pain relief options. Regional block was performed for 41 pregnancies...
June 2009: Thrombosis and Haemostasis
J P Cata, A Hanna, J E Tetzlaff, A Bishai, S Barsoum
Von Willebrand disease is the most common inherited bleeding disorder. No consensus exists about the use of neuraxial analgesia or anesthesia in patients with von Willebrand disease. We report on a 38-year-old multiparous woman who presented at 36 weeks' of gestation with spontaneous rupture of membranes for urgent cesarean delivery. Preoperative coagulation tests were normal except for prolonged platelet adhesion and aggregation tests. The cesarean delivery was performed under spinal anesthesia with hyperbaric bupivacaine, fentanyl and morphine sulfate...
July 2009: International Journal of Obstetric Anesthesia
Koji Hara, Nobuyuki Kishi, Takeyoshi Sata
Epidural anesthesia, combined with general anesthesia, was performed in a patient with type 1 von Willebrand disease (VWD). VWD is a common inherited bleeding disorder, and an anesthetic concern in patients with VWD is susceptibility to postoperative bleeding and epidural or spinal hematoma associated with neuraxial block. After confirming the patient's responsiveness to 1-desamino-8-D-arginine vasopressin (DDAVP) and obtaining informed consent, epidural anesthesia was performed to avoid the use of analgesics that inhibit platelet function...
2009: Journal of Anesthesia
Tetsuya Komada, Takashi Kawasaki, Takeyoshi Sata
Acquired von Willebrand syndrome (AvWS) is generic name of bleeding disorders caused by acquired decrease of von Willebrand factor. A 25-year-old woman with AvWS underwent emergent cesarean section under combined spinal and epidural anesthesia. Before operation, her APTT was within normal ranges. Platelet count was about 80,000 and factor VIII and von Willebrand factor's activities were 37% and 21%, respectively. Therefore, we administered 10 units of platelet concentrate and 2,000 units of factor VIII concentrate intravenously before the operation...
November 2013: Masui. the Japanese Journal of Anesthesiology
Sean P Riley, Melanie J Donnelly, Didi Khatib, Christopher Warren, Kristopher M Schroeder
PURPOSE: Spinal drains are used as a neuroprotective measure during thoracoabdominal aortic aneurysm (TAA) repair. Unfortunately, these drains can cause post-dural puncture headaches (PDPH). While PDPH following spinal anesthesia have been thoroughly evaluated, limited data exists about the incidence and risk factors for PDPH following spinal drains. Additionally, the efficacy of treatment with conservative therapies and epidural blood patches (EBP) for PDPH secondary to spinal drains has not been well documented...
August 2015: Journal of Anesthesia
Peng Chiong Tan, Anggeriana Andi, Noor Azmi, M N Noraihan
OBJECTIVE: To determine coital incidence at term and to estimate its effect on labor onset and mode of delivery. METHODS: Healthy women with uncomplicated pregnancies and established gestational age were recruited to keep a diary of coital activity from 36 weeks of gestation until birth and to answer a short questionnaire. Two hundred women with complete coital diaries were available for analysis. Outcome measures include coitus, postdate pregnancy (defined as pregnancy beyond the estimated date of confinement), gestational length of at least 41 weeks, labor induction at 41 weeks of gestation, and mode of delivery RESULTS: Reported sexual intercourse at term was influenced by a woman's perception of coital safety, her ethnicity, and her partner's age...
July 2006: Obstetrics and Gynecology
Peng Chiong Tan, Choon Ming Yow, Siti Zawiah Omar
OBJECTIVE: To estimate the effect of coitus on the onset of labor. METHODS: Women with a nonurgent labor induction at term were recruited. Women randomly assigned to the advised-coitus group were encouraged to have sex to promote the onset of labor. Controls were neither encouraged nor discouraged regarding coitus. Participants kept a coital and orgasm diary until delivery, and standard obstetric care was provided to both groups. Primary outcomes were reported coitus and spontaneous labor...
October 2007: Obstetrics and Gynecology
Yansong Li, Jing Wang, Xinchuan Wei
No abstract text is available yet for this article.
July 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
G Lambert, J F Brichant, G Hartstein, V Bonhomme, P Y Dewandre
Preeclampsia was formerly defined as a multisystemic disorder characterized by new onset of hypertension (i.e. systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg) and proteinuria (> 300 mg/24 h) arising after 20 weeks of gestation in a previously normotensive woman. Recently, the American College of Obstetricians and Gynecologists has stated that proteinuria is no longer required for the diagnosis of preeclampsia. This complication of pregnancy remains a leading cause of maternal morbidity and mortality...
2014: Acta Anaesthesiologica Belgica
Chris Crawford
No abstract text is available yet for this article.
March 2015: Annals of Family Medicine
Michael Schepke
No abstract text is available yet for this article.
September 2007: Nephrology, Dialysis, Transplantation
Randy W Loftus, Mark P Yeager, Jeffrey A Clark, Jeremiah R Brown, William A Abdu, Dilip K Sengupta, Michael L Beach
BACKGROUND: Ketamine is an N-methyl-d-aspartate receptor antagonist that has been shown to be useful in the reduction of acute postoperative pain and analgesic consumption in a variety of surgical interventions with variable routes of administration. Little is known regarding its efficacy in opiate-dependent patients with a history of chronic pain. We hypothesized that ketamine would reduce postoperative opiate consumption in this patient population. METHODS: This was a randomized, prospective, double-blinded, and placebo-controlled trial involving opiate-dependent patients undergoing major lumbar spine surgery...
September 2010: Anesthesiology
Michael S Avidan, Eric Jacobsohn, David Glick, Beth A Burnside, Lini Zhang, Alex Villafranca, Leah Karl, Saima Kamal, Brian Torres, Michael O'Connor, Alex S Evers, Stephen Gradwohl, Nan Lin, Ben J Palanca, George A Mashour
BACKGROUND: Unintended intraoperative awareness, which occurs when general anesthesia is not achieved or maintained, affects up to 1% of patients at high risk for this complication. We tested the hypothesis that a protocol incorporating the electroencephalogram-derived bispectral index (BIS) is superior to a protocol incorporating standard monitoring of end-tidal anesthetic-agent concentration (ETAC) for the prevention of awareness. METHODS: We conducted a prospective, randomized, evaluator-blinded trial at three medical centers...
August 18, 2011: New England Journal of Medicine
Richard Hall, C David Mazer
In the normal course of the delivery of care, anesthesiologists encounter many patients who are receiving drugs that affect platelet function as a fundamental part of primary and secondary management of atherosclerotic thrombotic disease. There are several antiplatelet drugs available for use in clinical practice and several under investigation. Aspirin and clopidogrel (alone and in combination) have been the most studied and have the most favorable risk-benefit profiles of drugs currently available. Prasugrel was recently approved for patients with acute coronary syndrome undergoing percutaneous interventions...
February 2011: Anesthesia and Analgesia
Emmanuel Futier, Jean-Michel Constantin, Catherine Paugam-Burtz, Julien Pascal, Mathilde Eurin, Arthur Neuschwander, Emmanuel Marret, Marc Beaussier, Christophe Gutton, Jean-Yves Lefrant, Bernard Allaouchiche, Daniel Verzilli, Marc Leone, Audrey De Jong, Jean-Etienne Bazin, Bruno Pereira, Samir Jaber
BACKGROUND: Lung-protective ventilation with the use of low tidal volumes and positive end-expiratory pressure is considered best practice in the care of many critically ill patients. However, its role in anesthetized patients undergoing major surgery is not known. METHODS: In this multicenter, double-blind, parallel-group trial, we randomly assigned 400 adults at intermediate to high risk of pulmonary complications after major abdominal surgery to either nonprotective mechanical ventilation or a strategy of lung-protective ventilation...
August 1, 2013: New England Journal of Medicine
Michael S Avidan, Lini Zhang, Beth A Burnside, Kevin J Finkel, Adam C Searleman, Jacqueline A Selvidge, Leif Saager, Michelle S Turner, Srikar Rao, Michael Bottros, Charles Hantler, Eric Jacobsohn, Alex S Evers
BACKGROUND: Awareness during anesthesia is a serious complication with potential long-term psychological consequences. Use of the bispectral index (BIS), developed from a processed electroencephalogram, has been reported to decrease the incidence of anesthesia awareness when the BIS value is maintained below 60. In this trial, we sought to determine whether a BIS-based protocol is better than a protocol based on a measurement of end-tidal anesthetic gas (ETAG) for decreasing anesthesia awareness in patients at high risk for this complication...
March 13, 2008: New England Journal of Medicine
2015-03-14 04:53:05
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