International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2021
Observational StudyIncidence, severity, and determinants of uterine contraction pain after vaginal delivery: a prospective observational study.
Postpartum uterine contraction pain has not been studied sufficiently. We aimed to assess the incidence, intensity, and risk factors for postpartum uterine contraction pain. ⋯ Postpartum uterine contraction pain is common and severe in some women. Parity and history of dysmenorrhea are significant risk factors for significant postpartum uterine contraction pain.
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Int J Obstet Anesth · May 2021
ReviewPlacenta accreta spectrum disorder: updates on anesthetic and surgical management strategies.
Placenta accreta spectrum (PAS) is a leading contributor to major obstetric hemorrhage and severe maternal morbidity in the developed world. In the United States, PAS has become the most common cause of peripartum hysterectomy. Over the last 40 years, clinicians have also witnessed a dramatic increase in the incidence of PAS. ⋯ As a consequence, obstetric anesthesiologists are increasingly likely to be called upon to manage women with suspected PAS for delivery. Given the increasing incidence and the morbidity burden associated with PAS, anesthesiologists play a vital role in optimizing maternal outcomes for women with PAS. This review will provide up-to-date information on nomenclature, pathophysiology, risk factors, antenatal detection, systemic preparations (includes timing of delivery, location of surgery, pre-operative evaluation and patient positioning), surgical and anesthetic approach, intra-operative management, invasive radiology and postoperative plans.
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Int J Obstet Anesth · May 2021
Randomized Controlled TrialUse of high-resolution thermography as a validation measure to confirm epidural anesthesia in mice: a cross-over study.
Effective epidural anesthesia is confirmed in humans by sensory assessments but these tests are not feasible in mice. We hypothesized that, in mice, infrared thermography would demonstrate selective segmental warming of lower extremities following epidural anesthesia. ⋯ Thermography is a useful tool to confirm epidural catheter placement in animals for which subjective, non-noxious, sensory measures are impossible.
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Int J Obstet Anesth · May 2021
Are we listening? Obstetric anesthesiology and the national call for birth justice and accountability: a perspective from the United States.
Despite declining rates of pregnancy-related deaths worldwide, the United States (US) has seen an increase in maternal mortality. It is widely known that this increased risk of mortality impacts unevenly Black people, who are three-fold more likely to die from pregnancy-related causes than white people. ⋯ On July 25, 2020, activists for reproductive justice and birth justice published an open call in the New York Times entitled "How many Black, Brown, and Indigenous people have to die giving birth? National call for birth justice and accountability." It is a powerful statement that uses an intersectional framework to understand reproductive inequities, while making demands for positive healthcare reforms and radically dreaming of a reality where the struggle for reproductive justice has been actualized. Using personal narrative, this paper reflects on the field of obstetric anesthesiology and how clinicians can make meaningful change to address and eventually help solve this health care inequity.