International journal of obstetric anesthesia
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Int J Obstet Anesth · Feb 2022
Case ReportsNeuraxial anesthesia in a parturient with common variable immunodeficiency: a case report.
Choosing whether or not to initiate neuraxial anesthesia in pregnant women with immune system defects may be challenging. Anesthesiologists have the responsibility of making the best decision in terms of anesthesia management for both mother and baby during the labor and delivery process. Whether neuraxial anesthesia is associated with an increased risk of central nervous system infection in immunocompromised compared with healthy patients is unknown. ⋯ There are no guidelines regarding the indications and limitations of regional anesthesia procedures in these patients. Immunocompromised patients are now seen more commonly, and it is essential to adopt a multidisciplinary approach to their care while tailoring anesthetic plans to the individual. We present the case of a 37-year-old parturient who had a congenital immune deficiency and who developed aseptic meningitis after receiving spinal anesthesia for cesarean delivery.
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Int J Obstet Anesth · Feb 2022
Neuraxial anesthesia and postoperative opioid administration for cesarean delivery in patients with placenta accreta spectrum disorder: a retrospective cohort study.
There is no consensus on optimal anesthetic and analgesic management of patients presenting for cesarean delivery with suspected placenta accreta spectrum disorder. Neuraxial anesthesia is preferred for uncomplicated procedures, but general anesthesia may be indicated for those at risk of hemorrhage and hysterectomy. We compared the effect of anesthesia techniques on postoperative maternal opioid administration and neonatal respiratory distress. ⋯ Patients receiving general anesthesia alone were administered more opioids than those undergoing neuraxial anesthesia or neuraxial with conversion to general anesthesia. This finding was maintained when accounting for whether or not the patient underwent hysterectomy. Deciding on anesthetic management requires consideration of patient comorbidities, severity of placenta accreta spectrum pathology, and surgical requirements.
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Int J Obstet Anesth · Feb 2022
Observational StudyValidation of an obstetric quality of recovery scoring tool (ObsQoR-11) after elective caesarean delivery in a developing country: a prospective observational study.
The obstetric quality of recovery scoring tool (ObsQoR-11) was developed and validated in the United Kingdom for use after elective and emergency caesarean delivery. Quality of recovery scoring tools validated in one country may not be valid in other countries with significant cultural, socio-economic and linguistic variations. The aim of the current study was to validate a Hindi version of the ObsQoR-11. ⋯ The Hindi version of the ObsQoR-11 questionnaire is a promising scoring tool to evaluate quality of recovery after elective caesarean delivery. Further research is needed to evaluate the Hindi tool in other institutions in India as well as in other languages.
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Int J Obstet Anesth · Feb 2022
Review Case ReportsPostpartum cerebral venous sinus thrombosis following obstetric neuraxial blockade: a literature review with analysis of 58 case reports.
Cerebral venous sinus thrombosis (CVST) is a rare complication of pregnancy. It usually presents with a headache and may mimic a post-dural puncture headache (PDPH) in women who receive a neuraxial block. ⋯ The diagnosis of CVST may be overlooked in women who present with headache following neuraxial block. A change in character of headache with loss of postural element, and focal neurological signs are the key clinical features that could help anaesthetists differentiate headache of CVST from PDPH. The high reported rates of ADP and PDPH lend support to their possible association with CVST.