International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2015
Multicenter StudyMechanical ventilation in critically-ill pregnant women: a case series.
Approximately 0.1-0.2% of pregnancies are complicated by respiratory failure requiring mechanical ventilatory support, but few data exist to inform clinical management. This study aimed to characterize current practice and the effect of delivery on respiratory function. ⋯ Review of current practice in four centers suggests that mechanical ventilation in pregnant patients follows usual guidelines applicable to non-pregnant patients. Delivery was associated with modest improvement in maternal respiratory function in some patients. Any potential benefit of delivery in improving maternal physiology must be weighed against the stress of delivery. The risks of premature birth for the fetus must be weighed against continued exposure to maternal hypoxemia and hypotension.
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Int J Obstet Anesth · Nov 2015
Randomized Controlled TrialThe use of phenylephrine to obtund oxytocin-induced hypotension and tachycardia during caesarean section.
Oxytocin causes clinically significant hypotension and tachycardia. This study examined whether prior administration of phenylephrine obtunds these unwanted haemodynamic effects. ⋯ Intravenous phenylephrine 50 μg immediately before 3U oxytocin during elective caesarean section does not prevent maternal hypotension and tachycardia.
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Int J Obstet Anesth · Nov 2015
Anesthetic management of placenta accreta in a low-resource setting: a case series.
Current recommendations for the anesthetic management of placenta accreta support a conservative approach with neuraxial anesthesia and uterine artery embolization. These are based on case series from experienced centers in developed countries. The aim of this study was to describe the anesthetic management of placenta accreta in a low-resource setting. ⋯ A multidisciplinary approach can prove valuable when placenta accreta is suspected before delivery. In low-resource settings, lack of interventional radiology services and prenatal diagnostic capability may have an impact on anesthetic management in patients with placenta accreta. However, other than greater blood loss, our study demonstrated that good maternal and neonatal outcomes are possible in spite of limited resources.
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Int J Obstet Anesth · Nov 2015
Letter Case ReportsMaternal collapse secondary to aortocaval compression.