Obstetrics and gynecology
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High-risk pregnancies require specialized obstetric and anesthetic care. A basic understanding of how specific pathophysiology and pharmacologic therapy interact with anesthetic care is essential for both obstetrician and anesthesiologist. This paper selectively focuses on preeclampsia/eclampsia, diabetes mellitus, prematurity, multiple gestations, infectious disease, preexisting neurologic disease, and preexisting cardiac disease, reviewing anesthesia for labor and vaginal and cesarean delivery for each high-risk problem, as practiced at a Level III perinatal unit. Emphasis will be placed, when appropriate, on recent experience with monitoring and aggressive pharmacologic therapy of the critically ill parturient.
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Obstetrics and gynecology · Jun 1987
The epidemiology and pathology of maternal mortality: Charity Hospital of Louisiana in New Orleans, 1965-1984.
Eighty-nine maternal deaths occurred at Charity Hospital of New Orleans between 1965 and 1984, for an overall rate of 60.8 per 100,000 live births. The mortality rate increased with increasing maternal age, was greater with cesarean than vaginal delivery, and has not continued to decline over the 20-year interval. ⋯ Although the majority of obstetric deaths were attributable to complications of hypertension, hemorrhage, and infection, the single most common cause at autopsy was pulmonary edema. Potentially preventable pulmonary edema was responsible for one-third of the obstetric deaths from hypertension and hemorrhage.