International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 1998
Anaesthetic management of a parturient with severe congenital factor XI deficiency undergoing caesarean section for triplet pregnancy.
The report describes the anaesthetic management of a Jewish patient of Ashkenazi descent with severe factor XI deficiency complicated by thrombocytopenia for caesarean section for triplets at the 35th week of gestation. Perioperative management consisted of sustained replacement therapy with fresh frozen plasma and platelets until the sixth postoperative day. General anaesthesia was used for the procedure. No other maternal or neonatal complications occurred.
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Int J Obstet Anesth · Jan 1998
Epidural analgesia for vaginal delivery in a patient with cystic fibrosis following double lung transplantation.
The anaesthetic management is described of a patient with cystic fibrosis who had had a double lung transplantation for intractable respiratory failure. An epidural block provided analgesia/anaesthesia for vaginal birth and bilateral tubal ligation.
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Int J Obstet Anesth · Jan 1998
Complications of obstetric epidural analgesia and anaesthesia: a prospective analysis of 10,995 cases.
Although epidural anaesthesia and analgesia are widely used in obstetrics, there are no large contemporary prospective series detailing associated complications. Prospective data was collected on all obstetric epidural blocks performed for labour and delivery in a single institution between July 1989 and August 1994. A data entry sheet was compiled and entered onto a computer database. ⋯ There was no major local anaesthetic toxicity or neurological deficit. The incidence of potentially life-threatening morbidity was thus 0.02% although in both cases outcome was good. The only persisting complication was neurological, an apparent epidural catheter-induced traumatic mononeuropathy.
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Int J Obstet Anesth · Jan 1998
Randomized Controlled Trial Clinical TrialEpidural lidocaine for cesarean delivery of the distressed fetus.
Lidocaine with epinephrine and sodium bicarbonate has a rapid onset of action. We therefore wished to compare its use with that of chloroprocaine for urgent cesarean delivery. Thirty parturients for cesarean section under epidural anesthesia were divided into three groups. ⋯ Lidocaine was detectable in maternal serum from four of the urgent cases and all of the elective cases. It was detectable in five neonates from the elective group but none from the emergency group. In parturients with preexisting epidural catheters and a baseline epidural infusion to maintain a T10 sensory level, chloroprocaine is faster in onset than lidocaine, but the difference in this study was only 1.3 min, and both agents provided excellent anesthesia.
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Int J Obstet Anesth · Jan 1998
Pregnancy and delivery in a patient with recent peripartum cardiomyopathy.
We present a case of successful pregnancy and delivery in a patient with peripartum cardiomyopathy who conceived only 3 months after a vaginal delivery complicated by peripartum cardiomyopathy. Following the onset of labor, an arterial pressure catheter and pulmonary artery catheter were placed. ⋯ After a few hours of labor, the fetal heart rate tracing revealed repetitive variable decelerations, and a decision was made to proceed with operative delivery. The mother's hemodynamic changes are presented, and the specifics of the anesthetic care are outlined.