International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2014
ReviewOutcomes in pregnant women with acute aortic dissections: a review of the literature from 2003 to 2013.
Acute aortic dissection in pregnant women is a rare but potentially life-threatening event. Our aim was to evaluate maternal and fetal outcomes of acute aortic dissection during pregnancy. ⋯ Despite advances in diagnostic and surgical techniques, maternal and fetal mortalities in pregnant patients with aortic dissection remain high. Patients undergoing combined cesarean section with aortic repair had favorable fetal outcomes.
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Mirror syndrome (Ballantyne syndrome, triple edema, maternal hydrops, pseudotoxemia) is a rarely diagnosed condition associated with pregnancy that can be life-threatening for both the mother and fetus. There is limited literature on its pathogenesis and anesthetic management, making prevention and treatment complex. The duration of pregnancy and severity of maternal or fetal presentation often determines outcome. We describe the anesthetic considerations of a morbidly obese parturient with Mirror syndrome.
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Int J Obstet Anesth · Nov 2014
The relationship between body mass index and post-dural puncture headache in obstetric patients.
Difficult epidural insertion and accidental dural puncture are more likely in the obese pregnant population. Low-level evidence suggests that the risk of post-dural puncture headache declines as body mass index increases. ⋯ This retrospective study found no evidence that women of higher body mass index are less likely to develop a post-dural puncture headache or that the characteristics of the headache and use of epidural blood patch were different.
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Int J Obstet Anesth · Nov 2014
Anesthetic and obstetric outcomes in morbidly obese parturients: a 20-year follow-up retrospective cohort study.
In 1993, Hood and Dewan published the results of a trial comparing obstetric and anesthetic outcomes of 117 morbidly obese parturients with matched controls. The authors demonstrated a higher initial epidural anesthesia failure rate, a higher cesarean delivery rate and an increased risk of obstetric complications. We replicated the previous study to provide updated information on outcomes in the morbidly obese pregnant population. We hypothesized that morbidly obese women would still have higher complication and failure rates compared to matched controls and that general anesthesia would be less commonly used than in the previous study. ⋯ Morbidly obese parturients are still at increased risk for antenatal comorbidities, failed labor analgesia, longer first stage of labor and operative delivery. Replacement labor epidural catheters and general anesthesia for cesarean delivery are less commonly required anesthetic techniques compared to the original study.
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Int J Obstet Anesth · Nov 2014
Evaluation of a prospectively administered written questionnaire to reduce the incidence of suspected latex anaphylaxis during elective cesarean delivery.
Life-threatening anaphylaxis has been reported in women exposed to latex during surgery. We compared a written screening questionnaire to identify suspected latex sensitivity with a verbal inquiry used previously in a historical control group of women undergoing cesarean delivery to determine if the incidence of suspected latex anaphylaxis could be reduced. ⋯ Use of the written screening questionnaire was associated with fewer cases of suspected anaphylaxis during cesarean delivery compared with the historical control. Most women with suspected anaphylaxis did not perform allergy testing; however, all who did were positive for latex.