2,258 results match your criteria International Journal of Obstetric Anesthesia [Journal]


Design errors in vital sign charts used in consultant-led maternity units in the United Kingdom.

Int J Obstet Anesth 2019 Jan 8. Epub 2019 Jan 8.

Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University, Bournemouth, UK.

Background: Paper-based charts remain the principal means of documenting the vital signs of hospitalised pregnant and postnatal women. However, poor chart design may contribute to both incorrect charting of data and clinical responses. We decided to identify design faults that might have an adverse clinical impact. Read More

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http://dx.doi.org/10.1016/j.ijoa.2019.01.001DOI Listing
January 2019

Anesthesia for non-obstetric surgery during pregnancy in a tertiary referral center: a 16-year retrospective, matched case-control, cohort study.

Int J Obstet Anesth 2019 Jan 12. Epub 2019 Jan 12.

Department of Anesthesiology, University Hospitals of the KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.

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. Read More

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http://dx.doi.org/10.1016/j.ijoa.2019.01.006DOI Listing
January 2019

Metaraminol use during spinal anaesthesia for caesarean section: a meta-analysis of randomised controlled trials.

Int J Obstet Anesth 2019 Jan 25. Epub 2019 Jan 25.

Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. Electronic address:

Introduction: During caesarean section, the use of a vasopressor is often required to achieve haemodynamic stability of the parturient. Metaraminol is a vasopressor used in this context in some countries. However, the differences between metaraminol and other vasopressors remain unclear. Read More

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http://dx.doi.org/10.1016/j.ijoa.2019.01.009DOI Listing
January 2019

Propofol, Zola, and the modern obstetric rapid sequence induction.

Authors:
E-J Smith P Groves

Int J Obstet Anesth 2019 Jan 11. Epub 2019 Jan 11.

Hospital NHS Foundation Trust, London, United Kingdom.

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http://dx.doi.org/10.1016/j.ijoa.2019.01.005DOI Listing
January 2019

Maternal respiratory distress and successful reversal with sugammadex during intrauterine transfusion with fetal paralysis.

Int J Obstet Anesth 2019 Jan 8. Epub 2019 Jan 8.

Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, Nova Scotia, Canada.

A 70 kg, 34-year-old woman at 29 weeks-of-gestation required intrauterine transfusion for Rh (D) alloimmunization. In the ambulatory treatment clinic, 19 mg of rocuronium was administered intramuscularly in split doses into the fetal buttock. The fetus moved and inadvertent maternal neuromuscular blockade occurred, leading to respiratory distress. Read More

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http://dx.doi.org/10.1016/j.ijoa.2019.01.002DOI Listing
January 2019

Baseline parameters for rotational thromboelastometry (ROTEM®) in healthy women undergoing elective caesarean delivery: a prospective observational study in Australia.

Int J Obstet Anesth 2019 Jan 16. Epub 2019 Jan 16.

Department of Anaesthesia and Perioperative Services, The Royal Brisbane and Women's Hospital, QLD, Australia; The University of Queensland, Brisbane, QLD, Australia.

Background: Formal reference ranges for rotational thromboelastometry (ROTEM®) in pregnancy have not been obtained in the recommended minimum sample size of 120. This prospective observational study aimed to establish baseline parameters in an Australian population of women undergoing elective caesarean delivery. The secondary aim was to compare these reference ranges with those from prior studies and the manufacturer. Read More

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http://dx.doi.org/10.1016/j.ijoa.2019.01.008DOI Listing
January 2019

The comparative accuracy of a handheld and console ultrasound device for neuraxial depth and landmark assessment.

Int J Obstet Anesth 2019 Jan 11. Epub 2019 Jan 11.

Division of Anesthesia, Critical Care and Pain, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Background: The study aimed to compare the accuracy of epidural depth estimation of a handheld ultrasound device, with an integrated algorithm that estimates epidural depth (AU; Accuro, Rivanna Medical), to that of a console ultrasound machine (GU; GE LOGIC S8).

Methods: Women requesting labor epidural analgesia consented to this prospective cohort study. The L2/3, L3/4, and L4/5 interspaces and the respective depths to the epidural space were identified, marked and measured using an AU and GU. Read More

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http://dx.doi.org/10.1016/j.ijoa.2019.01.004DOI Listing
January 2019

Optic nerve ultrasonography for evaluating increased intracranial pressure in severe preeclampsia.

Int J Obstet Anesth 2019 Jan 6. Epub 2019 Jan 6.

Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.

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http://dx.doi.org/10.1016/j.ijoa.2018.12.010DOI Listing
January 2019

Reply: Optic nerve ultrasonography for evaluating increased intracranial pressure in severe preeclampsia.

Int J Obstet Anesth 2019 Jan 6. Epub 2019 Jan 6.

Department of Cardiology, University Medical Center Ljubljana, Slovenia.

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http://dx.doi.org/10.1016/j.ijoa.2018.12.009DOI Listing
January 2019

Syncope after administration of epidural analgesia in an obstetric patient with a vagus nerve stimulator.

Authors:
J E Tang J B Hyman

Int J Obstet Anesth 2019 Jan 6. Epub 2019 Jan 6.

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box 1010, New York, NY 10029, United States. Electronic address:

Vagus nerve stimulation (VNS) is an adjunctive therapy for medically refractory epilepsy and depression. Vagus nerve stimulation is generally well-tolerated, but cardiac arrhythmias or asystole are rare complications that have been reported. This case report describes an obstetric patient who received epidural analgesia and subsequently experienced two episodes of syncope synchronous with stimulation from her VNS device. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.12.011DOI Listing
January 2019

Treatment of obstetric post-dural puncture headache. Part 1: conservative and pharmacological management.

Int J Obstet Anesth 2018 Dec 21. Epub 2018 Dec 21.

Department of Anaesthetics, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.

The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. One woman received an epidural blood patch, the other did not, but both suffered with chronic headaches following discharge from hospital. Neither woman was adequately followed-up. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.12.006DOI Listing
December 2018
1 Read

Treatment of obstetric post-dural puncture headache. Part 2: epidural blood patch.

Int J Obstet Anesth 2018 Dec 22. Epub 2018 Dec 22.

Department of Anaesthetics, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.

The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. Despite suffering long-term headaches, neither woman was adequately followed-up after discharge from hospital. Death resulted from a cerebral vein thrombosis in one case and a subdural haematoma in the other. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.12.005DOI Listing
December 2018
1 Read

Comparison of the potency of phenylephrine and norepinephrine bolus doses used to treat post-spinal hypotension during elective caesarean section.

Int J Obstet Anesth 2018 Dec 13. Epub 2018 Dec 13.

Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

Background: Phenylephrine, although considered the vasopressor of choice, can cause reflex bradycardia and a fall in cardiac output. Norepinephrine, due to its direct positive chronotropic and reflex negative chronotropic actions, is expected to overcome this problem. However, limited information about its effective dose for management of post-spinal hypotension, and its potency compared to phenylephrine, is available. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183037
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http://dx.doi.org/10.1016/j.ijoa.2018.12.002DOI Listing
December 2018
9 Reads

Transabdominal continuous echocardiographic monitoring of fetuses.

Int J Obstet Anesth 2018 Dec 21. Epub 2018 Dec 21.

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.

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http://dx.doi.org/10.1016/j.ijoa.2018.12.007DOI Listing
December 2018
1 Read

Remifentanil patient-controlled analgesia in labour: six-year audit of outcome data of the RemiPCA SAFE Network (2010-2015).

Int J Obstet Anesth 2018 Dec 21. Epub 2018 Dec 21.

Department of Anaesthesiology, University Hospital Würzburg, Würzburg, Germany.

Background: The RemiPCA SAFE Network was established to set standards and monitor maternal and neonatal outcomes when using remifentanil for labour analgesia. The aim of this analysis was to describe the development of the network standard and to report maternal and neonatal outcome data, including severe adverse events.

Methods: Data sets of the RemiPCA SAFE Network database from the initial six consecutive years (2010-2015) were retrospectively analysed. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.12.004DOI Listing
December 2018
3 Reads

Accidental dural puncture during labor analgesia and obstetric outcomes in nulliparous women.

Int J Obstet Anesth 2018 Dec 12. Epub 2018 Dec 12.

Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, 63110, USA. Electronic address:

Background: The effect of accidental dural puncture during labor epidural analgesia on obstetric outcomes remains unexplored. In this retrospective cohort study, we tested the hypothesis that accidental dural puncture is associated with prolonged second stage of labor.

Methods: Anesthetic and obstetric data from nulliparous parturients who suffered an accidental dural puncture at term labor (n=89) during the years 2006-2012 were compared with randomly selected parturients with uncomplicated epidural analgesia (n=232). Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.12.001DOI Listing
December 2018
1 Read
1.832 Impact Factor

In vitro intravenous fluid co-load rates with and without an intravenous fluid warming device.

Int J Obstet Anesth 2018 Dec 18. Epub 2018 Dec 18.

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ijoa.2018.12.003DOI Listing
December 2018

Epidural hematoma following low molecular weight heparin prophylaxis and spinal anesthesia for cesarean delivery.

Int J Obstet Anesth 2019 Feb 26;37:118-121. Epub 2018 Sep 26.

Department of Anesthesiology, University of Arizona, Tucson, AZ, USA. Electronic address:

Epidural hematoma is a very uncommon complication of spinal anesthesia. Its incidence has been reported to be between 1:200 000-250 000 in the obstetric population following neuraxial anesthesia. Cesarean delivery increases the risk of maternal venous thromboembolism significantly and recommendations to decrease its incidence and morbidity have been developed. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.09.008DOI Listing
February 2019
2 Reads

Ultrasound guided L5-S1 placement of labor epidural does not improve dermatomal block in parturients.

Int J Obstet Anesth 2018 Nov 20. Epub 2018 Nov 20.

Department of Anesthesia and Critical Care, University of Chicago, Chicago, United States of America.

Background: Based on their experience or training, anesthesiologists typically use the iliac crest as a landmark to choose the L3-4 or L2-3 interspace for labor epidural catheter placement. There is no evidence-based recommendation to guide the exact placement. We hypothesized that lower placement of the catheter would lead to a higher incidence of S2 dermatomal block and improved analgesia in late labor and at delivery. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183033
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http://dx.doi.org/10.1016/j.ijoa.2018.11.005DOI Listing
November 2018
2 Reads

In reply.

Int J Obstet Anesth 2019 Feb 17;37:138. Epub 2018 Nov 17.

The University of Queensland, Faculty of Medicine and Department of Obstetrics and Gynaecology and Obstetric Medicine, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

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http://dx.doi.org/10.1016/j.ijoa.2018.11.003DOI Listing
February 2019

How low did we go? A case report of unexpected thrombocytopenia.

Int J Obstet Anesth 2018 Nov 29. Epub 2018 Nov 29.

Columbia University Medical Center, Department of Anesthesiology, New York, United States of America.

We report the case of a normotensive 31-year-old parturient who received combined spinal-epidural analgesia for early labor, and who was then found to have an unexpectedly low platelet count (25 000/μL) with elevated liver enzymes, but without alterations in blood pressure. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183048
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http://dx.doi.org/10.1016/j.ijoa.2018.11.008DOI Listing
November 2018
1 Read

Blood pressure measurement in pregnancy.

Int J Obstet Anesth 2019 Feb 17;37:137-138. Epub 2018 Nov 17.

Department of Women's Health, King's College London, United Kingdom.

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http://dx.doi.org/10.1016/j.ijoa.2018.11.006DOI Listing
February 2019

Neuraxial labor analgesia, obstetrical outcomes, and the Robson 10-Group Classification.

Int J Obstet Anesth 2019 Feb 27;37:1-4. Epub 2018 Nov 27.

Department of Anesthesiology and Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, USA.

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183035
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http://dx.doi.org/10.1016/j.ijoa.2018.11.007DOI Listing
February 2019
1 Read

Acute hypoglycemia during cesarean delivery in a patient with Type-1 diabetes mellitus.

Int J Obstet Anesth 2018 Nov 17. Epub 2018 Nov 17.

Department of Anaesthesiology, Nara Medical University, Kashihara, Nara, Japan.

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http://dx.doi.org/10.1016/j.ijoa.2018.11.004DOI Listing
November 2018

Peri-operative considerations for in utero repair of myelomeningocele.

Int J Obstet Anesth 2019 Feb 23;37:135-136. Epub 2018 Oct 23.

Servicio de Obstetricia, Hospital Italiano de Buenos Aires, Argentina.

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http://dx.doi.org/10.1016/j.ijoa.2018.10.007DOI Listing
February 2019

Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands.

Int J Obstet Anesth 2018 Nov 2. Epub 2018 Nov 2.

Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Maxima Medical Centre, Veldhoven, The Netherlands.

Background: During labour, remifentanil patient-controlled analgesia is used as an alternative to neuraxial analgesia. Remifentanil is associated with hypoventilation and respiratory depression but the frequency of serious maternal and neonatal adverse events is unknown. The aim of this study was to estimate the number of serious adverse events attributed to the use of remifentanil patient-controlled analgesia during labour in The Netherlands and to investigate the circumstances (e. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.10.013DOI Listing
November 2018
1 Read

Massive hemorrhage protocol activation in obstetrics: a 5-year quality performance review.

Int J Obstet Anesth 2018 Nov 3. Epub 2018 Nov 3.

Department of Transfusion Medicine.

Background: A structured approach to hemorrhagic emergencies in obstetrics has gained popularity with the implementation of massive hemorrhage protocols. The trauma literature suggests that routine quality reviews should be in place to improve patient outcomes. The aim of this study was to develop quality indicators and assess compliance by the clinical team. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.10.004DOI Listing
November 2018
1 Read

Antenatal anaesthetic assessment clinics: a survey of United Kingdom practice.

Authors:
M D Roe W Nabeih

Int J Obstet Anesth 2019 Feb 17;37:139-141. Epub 2018 Nov 17.

East Suffolk and North Essex NHS Foundation Trust, Ipswich, United Kingdom.

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http://dx.doi.org/10.1016/j.ijoa.2018.11.002DOI Listing
February 2019

A 10-year update: national survey questionnaire of obstetric anesthesia units in Israel.

Int J Obstet Anesth 2018 Nov 2. Epub 2018 Nov 2.

Department of Anesthesiology, Perioperative Medicine & Pain Treatment, Shaare Zedek Medical Center, Affiliated with the Hadassah-Hebrew University Medical School Ein-Kerem, Jerusalem, Israel.

Background: This nationwide survey was conducted to provide data about the obstetric anesthesia services in Israeli labor and delivery units in 2016.

Methods: Prospective survey questionnaire was emailed to obstetric anesthesia unit directors/chairperson of all 25 labor and delivery services units within the jurisdiction of the Israeli Ministry of Health.

Results: The response rate was 100%. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.10.014DOI Listing
November 2018
1 Read

Are high-risk obstetric patients properly identified and managed?

Int J Obstet Anesth 2019 Feb 12;37:138-139. Epub 2018 Nov 12.

Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ijoa.2018.11.001DOI Listing
February 2019

Observational study evaluating obstetric anesthesiologist residents' wellbeing, anxiety and stress in a North American academic program.

Int J Obstet Anesth 2018 Nov 2. Epub 2018 Nov 2.

Department of Anesthesiology, Columbia University Medical Center, United States of America.

Background: The obstetrics work environment has a unique set of stressors that may be associated with burnout. We investigated how wellbeing during the obstetric anesthesia (ObA) rotation compared to other rotations; which workplace environment characteristics precipitated the greatest stress; and whether anxiety and stress levels changed in trainees before and after an ObA rotation.

Methods: Using a survey, anesthesia residents (N=36) ranked their wellbeing on each anesthesia rotation and answered questions about work environment. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.10.011DOI Listing
November 2018

Anaesthetic implications of a patient with cold-induced anaphylaxis presenting to the labour ward.

Int J Obstet Anesth 2019 Feb 26;37:125-128. Epub 2018 Sep 26.

Chelsea and Westminster Hospital, Magill Department of Anaesthesia, London, United Kingdom.

Cold contact urticaria is a well described condition, with reactions ranging from localised wheals to systemic and anaphylactic reactions. Case reports involving anaesthetic care are rare. This report describes a patient with cold-induced urticaria with systemic reactions who had been advised to carry an adrenaline autoinjector. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.09.009DOI Listing
February 2019
1 Read

Prophylactic infusion of phenylephrine is effective in attenuating the decrease in regional cerebral blood volume and oxygenation during spinal anesthesia for cesarean section.

Int J Obstet Anesth 2019 Feb 21;37:36-44. Epub 2018 Sep 21.

Department of Anesthesiology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan.

Background: Hypotension induced by spinal anesthesia for cesarean section causes a decrease in maternal regional cerebral blood volume and oxygenation. We used near-infrared spectroscopy to determine whether prophylactic infusion of phenylephrine attenuates these decreases.

Methods: Sixty patients undergoing bupivacaine spinal anesthesia for cesarean section were randomly divided into one of three intravenous infusion groups: saline (P0), phenylephrine 25 (P25) or 50 µg/min (P50). Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.09.006DOI Listing
February 2019

A prospective observational study of the change in regional cerebral oxygen saturation during cesarean delivery in women receiving phenylephrine prophylaxis for spinal hypotension.

Int J Obstet Anesth 2019 Feb 21;37:29-35. Epub 2018 Sep 21.

Department of Anesthesia, Rabin Medical Centre, Beilinson Hospital, 39 Jabotinski St., 49100 Petach Tikva, Israel.

Background: Spinal hypotension causes decreased regional cerebral oxygen saturation (ScO) in women undergoing cesarean delivery. In this study we aimed to measure the change in ScO using near infrared spectroscopy in women receiving a prophylactic phenylephrine infusion during cesarean delivery under spinal anesthesia.

Methods: This was a prospective, observational cohort study. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.09.005DOI Listing
February 2019
1 Read

Coagulopathy in obstetric cholestasis in Wessex Deanery.

Int J Obstet Anesth 2019 Feb 23;37:130-131. Epub 2018 Sep 23.

Poole Hospital NHS Foundation Trust, UK.

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http://dx.doi.org/10.1016/j.ijoa.2018.09.007DOI Listing
February 2019

Maternal critical care in resource-limited settings. Narrative review.

Int J Obstet Anesth 2019 Feb 29;37:86-95. Epub 2018 Sep 29.

Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa. Electronic address:

Maternal critical care reflects interdisciplinary care in any hospital area according to the severity of illness of the pregnant woman. The admission rate to intensive care units is below 1% (0.08-0. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.09.010DOI Listing
February 2019
1 Read

Is training in obstetric critical care adequate? An international comparison.

Int J Obstet Anesth 2019 Feb 12;37:96-105. Epub 2018 Sep 12.

Department of Anaesthetics, Royal Victoria Infirmary, Newcastle, United Kingdom.

Obstetric critical care is an emerging discipline which cuts across speciality boundaries. We have analysed the training curricula in the three major specialities (obstetrics, anaesthesia and intensive care medicine) likely to be involved in the care of the critically-ill obstetric patient, to assess whether it is adequate to ensure effective training on this subject. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.08.011DOI Listing
February 2019

Determination of ChloraPrep® drying time before neuraxial anesthesia in elective cesarean delivery. A prospective observational study.

Int J Obstet Anesth 2018 Nov 2. Epub 2018 Nov 2.

Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.

Background: ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It is believed that skin must be allowed to dry to prevent nerve damage by seeding ChloraPrep® solution into the neuraxis. We aimed to determine ChloraPrep® drying time in pregnant women before initiation of neuraxial anesthesia. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.10.012DOI Listing
November 2018
1 Read

Incidence of respiratory depression after epidural administration of morphine for cesarean delivery: findings using a continuous respiratory rate monitoring system.

Int J Obstet Anesth 2018 Oct 26. Epub 2018 Oct 26.

Department of Obstetrics and Gynecology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.

Background: Epidural morphine is widely used for postoperative analgesia after cesarean delivery. However, respiratory depression can occur after neuraxial administration of morphine. Previous reports describing respiratory depression in obstetric patients have relied on intermittent visual counting of the respiratory rate. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183027
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http://dx.doi.org/10.1016/j.ijoa.2018.10.009DOI Listing
October 2018
15 Reads

Effect of companion presence on maternal satisfaction during neuraxial catheter placement for labor analgesia: a randomized clinical trial.

Int J Obstet Anesth 2018 Oct 31. Epub 2018 Oct 31.

Department of Anesthesiology, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612, United States of America. Electronic address:

Background: Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183027
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http://dx.doi.org/10.1016/j.ijoa.2018.10.010DOI Listing
October 2018
7 Reads

Ephedrine versus phenylephrine as a vasopressor for spinal anaesthesia-induced hypotension in parturients undergoing high-risk caesarean section: meta-analysis, meta-regression and trial sequential analysis.

Int J Obstet Anesth 2019 Feb 19;37:16-28. Epub 2018 Oct 19.

Department of Anaesthesiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.

Background: Phenylephrine is the preferred vasopressor for the prevention and treatment of spinal anaesthesia-induced hypotension during caesarean section, because studies on low-risk elective patients found it to have a less detrimental effect on umbilical artery pH compared with ephedrine. However, limited data exist from high-risk parturients and parturients with uteroplacental insufficiency.

Methods: We systematically searched for randomised, controlled, double-blinded trials of these two vasopressors in high-risk caesarean sections. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.10.006DOI Listing
February 2019
8 Reads

Increasing body mass index and abdominal subcutaneous fat thickness are associated with increased skin-to-epidural space distance in pregnant women.

Int J Obstet Anesth 2018 Oct 19. Epub 2018 Oct 19.

Statistics Unit, Queensland Institute of Medical Research Berghofer, 300 Herston Rd, Herston 4006, Queensland, Australia.

Background: Body mass index does not indicate the distribution of adipose tissue. Central adiposity may be measured using ultrasound measurement of subcutaneous fat thickness. This study determined if the abdominal subcutaneous fat thickness measured correlated with skin-to-epidural space distance at delivery, and compared this with the booking body mass index. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.10.005DOI Listing
October 2018

Detecting pulmonary edema in multiple pregnancy through point-of-care lung ultrasonography.

Authors:
J Gu L L Luo

Int J Obstet Anesth 2019 Feb 24;37:129-130. Epub 2018 Oct 24.

Department of Anesthesiology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China. Electronic address:

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http://dx.doi.org/10.1016/j.ijoa.2018.10.008DOI Listing
February 2019

Obstetric anesthesia management of the patient with cardiac disease.

Int J Obstet Anesth 2019 Feb 27;37:73-85. Epub 2018 Sep 27.

Cardiovascular Division, John T. Milliken Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA.

Cardiovascular disease is the leading cause of maternal mortality in much of the developed world. Risk stratification models can predict which patients are at greatest risk for maternal or fetal morbidity or mortality. Particular cardiac diseases hold significant risk of mortality during pregnancy including pulmonary hypertension, aortic aneurysm, left-ventricular outflow tract obstruction, and severe cardiomyopathy. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.09.011DOI Listing
February 2019
2 Reads

Anaesthetic management for caesarean section of a parturient with a known difficult airway and closed spinal dysraphism.

Authors:
R Katz C L McCaul

Int J Obstet Anesth 2018 Oct 10. Epub 2018 Oct 10.

Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland.

Many anaesthetists consider patients with existing neurological deficits, untreated spinal pathology or those having undergone major spinal intervention to be precluded from undergoing neuraxial anaesthesia. While this is partly rooted in fears of litigation there is also a lack of consensus of the best practice in the anaesthetic management of these patients. We present our management of a parturient who attended our institution, having a number of anaesthetic complexities including a known difficult airway, spinal fusion and persistent spinal cord tethering. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183026
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http://dx.doi.org/10.1016/j.ijoa.2018.10.003DOI Listing
October 2018
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Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis.

Int J Obstet Anesth 2019 Feb 27;37:5-15. Epub 2018 Sep 27.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, South Korea.

Background: This study is a network meta-analysis to compare maternal and fetal outcomes associated with four different anesthetic techniques for cesarean delivery.

Methods: An arm-based, random-effects frequentist network meta-analysis was performed. A random effect model was selected considering deviance information criteria. Read More

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http://dx.doi.org/10.1016/j.ijoa.2018.09.012DOI Listing
February 2019
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Anesthetic management of parturients with Arnold Chiari malformation-I: a multicenter retrospective study.

Int J Obstet Anesth 2019 Feb 10;37:52-56. Epub 2018 Oct 10.

Department of Anesthesiology, Duke University Hospital, Durham, NC, United States.

Background: Consensus regarding the safest mode of delivery and anesthetic management for parturients with Arnold Chiari malformation-I (ACM-I) remains controversial. This study assessed their anesthetic management and reported anesthetic complications during hospitalization for delivery.

Methods: This was a multicenter, retrospective, cohort study of patients with ACM-I undergoing vaginal or cesarean delivery. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X183027
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http://dx.doi.org/10.1016/j.ijoa.2018.10.002DOI Listing
February 2019
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Antenatal hydration in POTS - could technology help?

Int J Obstet Anesth 2019 Feb 11;37:136-137. Epub 2018 Oct 11.

Anaesthetics Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.

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http://dx.doi.org/10.1016/j.ijoa.2018.10.001DOI Listing
February 2019

Uterotonic drug usage in Canada: a snapshot of the practice in obstetric units of university-affiliated hospitals.

Int J Obstet Anesth 2019 Feb 12;37:45-51. Epub 2018 Sep 12.

Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Canada; Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Canada. Electronic address:

Objective: The objective of this study was to determine the pattern of uterotonic drug usage in obstetric units of university-affiliated hospitals in Canada.

Methods: This was a prospective observational study conducted in the form of an electronic survey. The target group consisted of chiefs or directors of Obstetrics and Anaesthesia at university-affiliated hospitals across Canada. Read More

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February 2019
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Clearsight™ use for haemodynamic monitoring during the third trimester of pregnancy - a validation study.

Int J Obstet Anesth 2018 Nov 8;36:85-95. Epub 2018 May 8.

Clinical Investigation Center 1409, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France.

Background: We assessed the validity of Clearsight™ as a non-invasive cardiac output and stroke volume monitoring device, comparing it with transthoracic echocardiography measurements during the third trimester of pregnancy.

Methods: Measurements obtained from Clearsight™ were compared with those from echocardiography as the gold standard. The precision and accuracy of the Clearsight™ was measured using the Bland and Altman method. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0959289X173036
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http://dx.doi.org/10.1016/j.ijoa.2018.04.009DOI Listing
November 2018
6 Reads