International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2018
ReviewA review of blood pressure measurement in obese pregnant women.
Blood pressure monitoring is a critical component of antenatal, peripartum and postnatal care. The accurate detection and treatment of abnormal blood pressure during pregnancy is essential for the optimisation of maternal and neonatal outcomes. Increasing maternal obesity in western populations is well documented. ⋯ The limitations of the current validation protocols in pregnancy will be highlighted. It is concluded that a pregnancy-specific validation protocol is required: this would facilitate the introduction of new technology for use in high-risk pregnant women. More accurate blood pressure measurement has the potential to improve the diagnosis and management of abnormal blood pressure in pregnancy and influence maternal and neonatal outcomes.
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Heterotopic heart transplants were introduced in 1974. The technique allows the patient's native heart to be preserved in situ, alongside the transplanted heterotopic donor heart. We present the case of a nulliparous woman who underwent heterotopic heart transplant in infancy, and subsequent explantation of the donor heart eleven years later, when her native heart function recovered. ⋯ At 35 weeks-of-gestation she was admitted to hospital with preeclampsia. After blood pressure control and steroid administration, a category 3 caesarean delivery under spinal anaesthesia was performed. To our knowledge this is the first case report describing pregnancy in a patient with a removed heterotopic heart transplant.
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Int J Obstet Anesth · Aug 2018
Association between intrapartum epidural use and maternal postpartum depression presenting for medical care: a population-based, matched cohort study.
To evaluate whether intrapartum epidural use is associated with maternal postpartum depression presenting for medical care. ⋯ Intrapartum epidural use was not associated with maternal postpartum depression presenting to the healthcare system in term nulliparous women who had a vaginal delivery. Further research is needed to determine if intrapartum epidural use is associated with postpartum depression among women who don't seek care from a physician.
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Int J Obstet Anesth · Aug 2018
Case ReportsBronchoscopic resection of a tracheobronchial leiomyoma in a pregnant patient.
Flexible bronchoscopy, therapeutic bronchoscopy and other procedures requiring anesthesia are generally avoided in pregnancy and postponed until after delivery if possible. We report a case of a parturient with an abnormal chest radiograph and mild obstructive symptoms of unknown etiology. At bronchoscopy, a tumor associated with post-obstructive suppuration was found and excised using electrocautery snare and cryotherapy, for restoration of airway patency. Coordination between pulmonary, obstetric, anesthesia, neonatology and thoracic surgery services was essential in ensuring success and the safety of the mother and fetus.