International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2013
Case ReportsRecurrent psychogenic paresis after dural puncture in a parturient.
We describe the case of a 29-year-old parturient who, after undergoing elective cesarean delivery, displayed symptoms of lower extremity weakness and sensory deficit. Her past medical history was significant for asymptomatic Arnold Chiari Type I malformation and asthma. She had received spinal anesthesia that failed to achieve an adequate surgical level requiring conversion to general anesthesia. ⋯ At 27 weeks of gestation, she had similar lower extremity symptoms after a lumbar puncture, performed to exclude meningitis for severe headache symptoms. Psychogenic paresis is not commonly reported in the medical literature and we found no reports of psychogenic paresis after spinal anesthesia in a parturient or recurrent psychogenic paresis. We review the various risk factors, etiology, neurological signs and symptoms, types, therapy and future management of a patient with recurrent conversion disorder.
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Int J Obstet Anesth · Apr 2013
Review Meta AnalysisA meta-analysis of the effect of inspired oxygen concentration on the incidence of surgical site infection following cesarean section.
There has been interest in using high inspired oxygen concentrations to reduce surgical site infections in the obstetric population. Previous meta-analyses looking at the effect of high-concentration oxygen in other surgical populations have reported conflicting results. However, no meta-analysis has been performed on women undergoing cesarean section, who are generally a healthier population and thus may have different outcomes. The aim of this study was to complete a meta-analysis comparing high (>60%) and low (<40%) inspired concentrations of oxygen and determine the risk of surgical site infections in patients undergoing cesarean section. ⋯ There is no evidence to suggest a difference in risk of surgical site infection by administration of high inspired oxygen concentrations among women undergoing cesarean section. Future studies with better adherence to the intervention may affect the results of this analysis.
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Int J Obstet Anesth · Apr 2013
Review Meta AnalysisUtility of B-type natriuretic peptides in preeclampsia: a systematic review.
Preeclampsia and its complications may be associated with elevated B-type natriuretic peptide levels during and after pregnancy. ⋯ Preeclampsia is associated with elevated natriuretic peptide levels. Cardiovascular complications and preterm delivery in this setting may also be associated with elevated natriuretic peptide levels. Large prospective studies of natriuretic peptide measurement in preeclampsia are needed to determine whether elevated levels predict the development of severe preeclampsia and/or associated complications.