International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2020
Multicenter StudyA population-based analysis of French transfusion practices for women experiencing severe postpartum hemorrhage.
Transfusion is a major therapy for severe postpartum hemorrhage but there are few population-based descriptions of practice. The objective of this retrospective French population-based study was to describe transfusion practices in women with severe postpartum hemorrhage and the compliance with guidelines. ⋯ One in five women with severe postpartum hemorrhage and a low hemoglobin concentration did not receive blood transfusion, which does not comply with French national recommendations. Over-transfusion occurred in women in whom bleeding had been controlled. The use of tools to help clinicians with transfusion decision-making should be developed.
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Int J Obstet Anesth · May 2020
Inadvertent neuraxial block placement at or above the L1-L2 interspace in the super-obese parturient: a retrospective study.
Increasing body mass index (BMI) increases the difficulty of neuraxial procedures. We hypothesized that it may put patients at risk for inappropriately high dural puncture. The accuracy of anesthesiologists' estimates of the interspinous level in super-obese parturients has not been studied. We evaluated the frequency of inadvertently high epidural and/or intrathecal catheter placement (at or above the L1/L2 interspace) in parturients of BMI ≥50 kg/m2. ⋯ A high rate of inadvertently high epidural or intrathecal catheter placement occurs in super-obese parturients. Ultrasound did not prevent this.
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Int J Obstet Anesth · May 2020
Letter Case ReportsIsolated chronic tinnitus after neuraxial labor analgesia.