International journal of obstetric anesthesia
-
Int J Obstet Anesth · Apr 2005
A prospective observational study of the use of the Proseal laryngeal mask airway for postpartum tubal ligation.
Though controversial, the risk of pulmonary aspiration during general anaesthesia in the immediate postpartum period appears low. The efficacy of the Proseal laryngeal mask airway was studied prospectively in a group of patients undergoing postpartum tubal ligation. ⋯ The Proseal laryngeal mask airway provides an effective airway for general anaesthesia in fasted patients undergoing tubal ligation from 8 h after normal vaginal delivery. While the safety of an unprotected airway in this population remains uncertain, this study suggested a low risk of regurgitation, especially in the first 24 h post partum.
-
Int J Obstet Anesth · Apr 2005
Maternal and fetal outcome of anaesthesia for caesarean delivery in preeclampsia/eclampsia in Enugu, Nigeria: a retrospective observational study.
Maternal mortality, for which preeclampsia is a major cause, is a problem in Nigeria. Accurate data are available for caesarean sections in the University of Nigeria Teaching Hospital, Enugu. We therefore studied the outcome of caesarean section among these high-risk patients. ⋯ Maternal and fetal mortality were high. Poverty, late presentation, lack of equipment and inexperienced management were major contributory factors. Use of spinal anaesthesia should be encouraged in view of recent favourable reviews and cheaper cost.
-
We present the case of a 29-year-old female who in her third pregnancy developed seizures seven days postpartum. The only symptoms preceding the seizures were headache and visual disturbance. ⋯ All symptoms resolved within 24 h of the first seizure. In this case report we highlight the difficulties in establishing the cause of postpartum seizures.
-
Int J Obstet Anesth · Apr 2005
What's new and novel in obstetric anesthesia? Contributions from the 2003 scientific literature.
THE PREGNANT PATIENT: Age; maternal disease; prophylactic antibiotics; gastroesophageal reflux; obesity; starvation; genotyping; coagulopathy; infection; substance abuse; altered drug responses in pregnancy; physiological changes of pregnancy. THE FETUS: Fetal monitoring; intrauterine surgery. THE NEWBORN: Breastfeeding; maternal infection, fever, and neonatal sepsis evaluation. ⋯ OBSTETRIC MANAGEMENT: External cephalic version and cervical cerclage; elective cesarean delivery; fetal malpresentation; vaginal birth after cesarean delivery; termination of pregnancy. OBSTETRIC ANESTHESIA: Analgesia for labor and delivery; anesthesia for cesarean delivery; anesthesia for short obstetric operations; complications of anesthesia. MISCELLANEOUS: Consent; ethics; history; labor support; websites/books/leaflets/journal announcements.
-
Int J Obstet Anesth · Apr 2005
Case ReportsFailed regional anesthesia with reduced spinal bupivacaine dosage in a parturient with achondroplasia presenting for urgent cesarean section.
A 36-year-old patient with a history of previous back surgery, asthma, latex allergy and achondroplasia presented for urgent cesarean delivery at 31 weeks' gestation for worsening nonimmune fetal hydrops. The fetus was diagnosed with trisomy 21 and achondroplasia. Because of the urgent clinical situation, the patient was given a spinal anesthetic, which required supplemental intravenous sedation after delivery of the fetus. This case report discusses the controversies in anesthetic management of this complicated patient and compromised fetus regarding general anesthesia, epidural, spinal and combined spinal-epidural anesthesia.