International journal of obstetric anesthesia
-
Int J Obstet Anesth · Nov 2013
Peak plasma anti-Xa levels after first and third doses of enoxaparin in women receiving weight-based thromboprophylaxis following caesarean section: a prospective cohort study.
Women undergoing caesarean section are at higher risk for thromboembolic complications following delivery than other parturients. The aim of this study was to determine whether higher doses of enoxaparin based on body weight are safe and more likely to achieve plasma anti-Xa levels within the accepted thromboprophylactic range. ⋯ The majority of women receiving weight-based enoxaparin thromboprophylaxis following caesarean section achieved plasma anti-Xa levels within the putative thromboprophylactic range. No woman achieved levels associated with an increased risk of bleeding (>0.8 IU/mL). These findings provide a safety basis for a large prospective study using this regimen.
-
Int J Obstet Anesth · Nov 2013
Outcomes of prospectively-collected consecutive cases of antenatal-suspected placenta accreta.
Accurate diagnosis of placenta accreta is tentative before surgery. This study developed a predictive score for antenatal diagnosis of placenta accreta through mathematical modeling using clinical signs. ⋯ Combining diagnostic features associated with placenta accreta through mathematical modeling has better positive predictive value than ultrasound alone.
-
Int J Obstet Anesth · Nov 2013
How UK obstetric anaesthetists assess neuraxial anaesthesia for caesarean delivery: National surveys of practice conducted in 2004 and 2010.
There is much interest in optimal methods of assessing neuraxial block before caesarean delivery. Although cold sensation is commonly used, some evidence suggests that the risk of intraoperative pain may be reduced by assessing light touch. We aimed to determine how neuraxial anaesthesia was managed perioperatively, and whether changes in clinical practice reflected the differing evidence in the literature over six years. ⋯ Methods of assessing neuraxial block differed from those recommended in the literature. The wide range of modalities, methods of testing and targeted sensory levels suggest that clearer recommendations on best practice for assessment and documentation of neuraxial block before caesarean delivery are required.