International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2014
Case ReportsPost-dural puncture headache and posterior reversible encephalopathy syndrome: a misdiagnosis or co-presentation?
Posterior reversible encephalopathy syndrome (PRES) is a rare neurological condition associated with a variety of underlying conditions, including preeclampsia. The headache associated with PRES may be indistinguishable from post-dural puncture headache, which may result in diagnostic delay. ⋯ The case was unique because there were no features of preeclampsia, initial presentation was typical of post-dural puncture headache, and there was a five-day interval between the onset of headache and the development of seizures and cortical blindness, pathognomonic of PRES. It remains unclear whether this was an atypical presentation of PRES, initially misdiagnosed as post-dural puncture headache, or whether delayed treatment of headache triggered PRES.
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Int J Obstet Anesth · Aug 2014
Multicenter Study Observational StudyBlood transfusion in patients having caesarean section: a prospective multicentre observational study of practice in three Pakistan hospitals.
Increasing awareness of the risks of blood transfusion has prompted examination of red cell transfusion practice in obstetrics. A six-month prospective observational study was performed to examine blood transfusion practices in patients undergoing caesarean delivery at three hospitals in Pakistan. ⋯ Blood transfusion was prescribed more readily in the public hospital. Identification of a transfusion trigger and the development of institutional guidelines to reduce unnecessary transfusion are required.
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Int J Obstet Anesth · Aug 2014
Utility of a low-cost wireless force platform as a potential clinical test of balance recovery after neuraxial anaesthesia.
Recovery of balance after neuraxial anaesthesia can remain delayed after simple clinical tests have demonstrated motor recovery. Dynamic posturography tracks the small movements or sway of a person standing as still as possible on a force platform and has been investigated as an objective measure of the ability to walk following anaesthesia. These are expensive laboratory devices, limiting their clinical utility. One measured variable is path length, the cumulative distance travelled in the horizontal plane by the centre of pressure of a person standing on the platform over 1min. Path length might potentially be measured using the Nintendo® Wii-Fit Balance Board™. ⋯ The path lengths were in close agreement and the Wii-Fit Balance Board™ may be worthy of further investigation as a tool to objectively assess readiness to ambulate following neuraxial anaesthesia.