International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2013
Editorial CommentPlacenta accreta: successful outcome is all in the planning.
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Int J Obstet Anesth · Nov 2013
ReviewAmniotic fluid embolism: a leading cause of maternal death yet still a medical conundrum.
Amniotic fluid embolism is a rare and potentially catastrophic condition that is unique to pregnancy. The presentation may range from relatively subtle clinical events to sudden maternal cardiac arrest. Despite an increased awareness of the condition, it remains a leading cause of maternal mortality. ⋯ This can result in a wide spectrum of clinical findings, with cardiovascular and haematological disturbances being prominent. The management of a suspected episode of amniotic fluid embolism is generally considered to be supportive, although in centres with specific expertise, echocardiography may assist in guiding management. Whilst outcomes after an episode of amniotic fluid embolism are still concerning, mortality would appear to have decreased in recent times, likely secondary to an improved awareness of the condition, advances in acute care and the inclusion of less severe episodes in case registries.
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Int J Obstet Anesth · Nov 2013
ReviewInteractive technology in obstetric anaesthesia and analgesia: exploring seamless solutions to jagged problems.
Perioperative care often involves treating rapid changes in a patient's physiological profile that requires timely intervention by anaesthetists. Interactive technology and closed-loop systems are currently developed in obstetric anaesthesia and analgesia for maintaining parameters during caesarean section and epidural analgesia. ⋯ The components of an interactive system such as the input sensor or device, microprocessor-based control unit and the effector are introduced. Developments in continuous, non-invasive blood pressure monitoring, control algorithms and smart pump technology would help to redefine how technology can assist obstetric anaesthetists to provide better care and improve clinical outcomes for pregnant women.