International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2013
Review Meta AnalysisUtility of B-type natriuretic peptides in preeclampsia: a systematic review.
Preeclampsia and its complications may be associated with elevated B-type natriuretic peptide levels during and after pregnancy. ⋯ Preeclampsia is associated with elevated natriuretic peptide levels. Cardiovascular complications and preterm delivery in this setting may also be associated with elevated natriuretic peptide levels. Large prospective studies of natriuretic peptide measurement in preeclampsia are needed to determine whether elevated levels predict the development of severe preeclampsia and/or associated complications.
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Int J Obstet Anesth · Apr 2013
Use of thromboelastography to assess the combined role of pregnancy and obesity on coagulation: a prospective study.
Thromboelastography (TEG®) is a point of care monitor of whole blood coagulation and has previously demonstrated hypercoagulability in both pregnant and obese populations. However, the individual and combined contribution of pregnancy and obesity on coagulation status has not been defined. We carried out a study to assess the effect of both pregnancy and body mass index (BMI) on blood coagulation using laboratory tests of coagulation and thromboelastography. ⋯ The combined effect of pregnancy and obesity on coagulation has not previously been investigated. Thromboelastographic comparison of pregnant and non-pregnant females separated into low or high BMI cohorts in the current study suggests that obesity correlates more with a hypercoagulable state than with pregnancy, particularly in pregnant patients at the extremes of low and high body weight.
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Int J Obstet Anesth · Apr 2013
Case ReportsAnaesthetic management of an obstetric patient with variegate porphyria.
Porphyria is an uncommon disease that can produce life-threatening attacks with a mortality rate of up to 10%, specifically as the result of administration of porphyrinogenic medications. In obstetric anaesthesia there are many situations where drugs are given in an emergency and it is therefore important to be prepared for complications to avoid inadvertently inducing an iatrogenic porphyric crisis. We discuss the case of a 20-year-old nulliparous woman with variegate porphyria who required an emergency caesarean section in labour, and the drugs that are commonly used in obstetric practice.