International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2017
Lessons learned from a single institution's retrospective analysis of emergent cesarean delivery following external cephalic version with and without neuraxial anesthesia.
To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. ⋯ In this single hospital's practice, patients who may be at higher risk of complications and have a lesser likelihood of success were provided NA for ECV. As a result, the use of neuraxial anesthesia for external cephalic version was associated with a higher rate of emergent cesarean delivery. Obstetric and anesthetic practices should evaluate their patient selection and procedure protocol for external cephalic version under neuraxial anesthesia.
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Previous studies have suggested an inverse relationship between obesity and development of post-dural puncture headache following spinal anesthesia. However, few have investigated the relationship between obesity and headaches after accidental dural puncture with an epidural needle. This study explored whether obesity has any association with headaches following an accidental dural puncture. ⋯ Patients with a high body mass index do not appear to be protected from experiencing a post-dural puncture headache after an accidental dural puncture during placement of labor epidural analgesia. Additionally, the intensity of post-dural puncture headache does not vary with body mass index.
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Int J Obstet Anesth · May 2017
Observational StudyImmediate postpartum neurological deficits in the lower extremity: a prospective observational study.
Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. ⋯ Transient neurological complications after labour and delivery are infrequent, mainly sensory involving multiple lumbosacral nerve roots or specific sacral cutaneous nerves, and they typically resolve within a short time.
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Int J Obstet Anesth · May 2017
Neuraxial analgesia in a pregnant woman with Fowler's syndrome and sacral neuromodulation.
We report the anesthetic management of a 16-year-old woman with Fowler's syndrome who became pregnant three years after sacral neuromodulation was initiated for treatment of the condition. Multidisciplinary consensus was to switch off the neurostimulator during pregnancy, and attempt vaginal delivery with a neuraxial block. ⋯ Sacral neuromodulation was restarted uneventfully in the early puerperium and the Fowler's syndrome remains well controlled. The baby continues to develop normally three years after delivery.
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Int J Obstet Anesth · May 2017
Case ReportsCaesarean delivery in a pregnant woman with epidermolysis bullosa: anaesthetic challenges.
Epidermolysis bullosa is a heterogeneous group of hereditary diseases characterised by extreme fragility of skin and mucosa, with blister and lesion formation spontaneously or in response to trauma. Anaesthetic management of these patients is challenging with respect to positioning, monitoring, use of medical devices and airway management. These challenges are increased when managing labour. We report an elective caesarean delivery in a nulliparous woman with autosomal recessive dystrophic epidermolysis bullosa, managed successfully with spinal anaesthesia.