International journal of obstetric anesthesia
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A 31-year-old woman gravida 4 para 2 who had received epidural analgesia during labour (duration of catheterization 6.5 h) was readmitted 8 days later with a complaint of flu-like symptoms, severe backache and numbness of her thighs. She had a sensory deficit from T4 to L1 and was unable to stand without support. The severe backache prevented adequate assessment of motor function. ⋯ Culture of the drained pus grew Streptococcus pneumoniae. She made a complete recovery and was discharged home on the tenth day. This case illustrates the problem of diagnosing serious postnatal problems that arise following the now fashionable early discharge from hospital.
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Int J Obstet Anesth · Apr 1997
Use of sublingual glyceryl trinitrate as a supplement to volatile inhalational anaesthesia in a case of uterine inversion.
We present a case of uterine inversion in which glyceryl trinitrate was used via the sublingual route, as opposed to the intravenous route, in association with volatile inhalational anaesthesia in order to achieve relaxation of the uterus. A transient, but significant, hypotensive response occurred, which was easily corrected with a colloid infusion and vasopressors. Sublingual glyceryl trinitrate is easily administered, has a fast onset of action and may have a role in situations where rapid relaxation of the uterus is required.
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Int J Obstet Anesth · Apr 1997
Anaesthesia and the antiphospholipid syndrome: a review of 20 obstetric patients.
The case notes of 20 obstetric patients with antiphospholipid syndrome delivering over a 4-year period were reviewed retrospectively. There were complete details for 22 singleton pregnancies. Obstetric complications in the pregnancies under review were frequent. ⋯ The estimated blood loss at these deliveries did not exceed 600 ml. Eleven women (55%) had a previous history of thrombosis. Two women had thrombotic episodes during their pregnancies and three had them post partum despite antithrombotic measures.
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Int J Obstet Anesth · Apr 1997
Breath pentane concentrations during labor and the effect of epidural analgesia on the pentane concentration.
Increased lipid peroxidation has been observed in pregnancy and particularly in preeclampsia. Pentane, a by-product of lipid peroxidation, can be measured in exhaled breath, and its measurement is considered a non-invasive method of assessing lipid peroxidation in vivo. We measured pentane levels in the breath of 36 healthy parturient women and examined the effect of epidural analgesia on the pentane level. ⋯ The breath pentane level was higher during labor (4.88 parts per billion [p.p.b.], 95% confidence interval 3.25-6.51 p.p.b.) than before the induction of labor (3.10 p.p.b., 95% confidence interval 2.01-4.19 p.p.b.). There was a significant decrease in the pentane level after the institution of epidural analgesia (2.27 p.p.b., 95% confidence interval 1.43-3.11 p.p.b.). Our results suggest that labor may be accompanied by an increase in lipid peroxidation, and epidural analgesia reverses this increase.