International journal of obstetric anesthesia
-
Int J Obstet Anesth · Feb 2019
ReviewObstetric anesthesia management of the patient with cardiac disease.
Cardiovascular disease is the leading cause of maternal mortality in much of the developed world. Risk stratification models can predict which patients are at greatest risk for maternal or fetal morbidity or mortality. ⋯ The obstetric anesthesiologist should formulate delivery plans for cardiac monitoring, labor analgesia, cesarean anesthesia, postpartum monitoring, as well as plans for obstetric or cardiac emergencies. Carefully co-ordinated multidisciplinary care of pregnant women with cardiac disease can result in successful outcomes.
-
Int J Obstet Anesth · Feb 2019
Comparative StudyComparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis.
This study is a network meta-analysis to compare maternal and fetal outcomes associated with four different anesthetic techniques for cesarean delivery. ⋯ Spinal and epidural anesthesia were ranked high regarding Apgar scores and epidural anesthesia was ranked high regarding umbilical venous pH, but the results were based on small heterogeneous studies with high or unclear risks of bias.
-
Int J Obstet Anesth · Feb 2019
Case ReportsEpidural hematoma following low molecular weight heparin prophylaxis and spinal anesthesia for cesarean delivery.
Epidural hematoma is a very uncommon complication of spinal anesthesia. Its incidence has been reported to be between 1:200 000-250 000 in the obstetric population following neuraxial anesthesia. ⋯ Strategies to decrease venous thromboembolism include pharmacologic prophylaxis with unfractionated or low molecular weight heparin. We report a case of spinal-epidural hematoma occurring in a parturient who received spinal anesthesia for a planned, repeat cesarean delivery after low molecular weight heparin thromboprophylaxis.