International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2009
Case ReportsAnesthetic management for cesarean delivery in a parturient with exacerbated hemophagocytic syndrome.
Hemophagocytic syndrome is an uncommon disease characterized by cytokine dysfunction and uncontrolled hemophagocytosis. It arises rarely during pregnancy, in which case maternal and fetal mortality are relatively high. It has some similarities with HELLP syndrome. ⋯ General anesthesia was provided successfully for cesarean delivery. The patient recovered completely after this episode. We suggest that early diagnosis, multi-disciplinary intervention, pre-operative correction of the hematological abnormalities, general anesthesia and close postoperative monitoring are necessary.
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Int J Obstet Anesth · Oct 2009
Case ReportsAcupuncture in the management of post-partum headache following neuraxial analgesia.
Women presenting with low pressure post-partum headache following neuraxial techniques are frequently offered an epidural blood patch, despite its inherent risks. We present two parturients with classical symptoms of low-pressure headache, who each received neuraxial labour analgesia without a documented dural puncture with a Tuohy needle. Both parturients were successfully managed using acupuncture rather than an epidural blood patch.
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Int J Obstet Anesth · Oct 2009
Editorial CommentBlood transfusions: more is not necessarily better.