International journal of obstetric anesthesia
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The report of the Expert Maternity Group 'Changing Childbirth' (The Cumberlege Report) advocates a greater role for midwives in the care of the low risk pregnant woman, and has promoted much discussion about the future development of maternity services in the UK. At Leicester Royal Infirmary NHS Trust the 'Home from Home' delivery scheme provides midwifery-led antenatal and intrapartum care of women with uncomplicated pregnancies. We have performed a retrospective review of the requirements for anaesthetic services in this unit. ⋯ One hundred and eighty one women subsequently received anaesthetic intervention. Of this group, 137 (77.0%) required an epidural, 17 (9.6%) a spinal, 18 (10.1%) a general anaesthetic, 5 (2.8%) an epidural and a general anaesthetic and 1 (0.6%) an epidural and a spinal. Our results demonstrate that low risk pregnant women in labour being cared for in a midwifery led unit have a considerable need for anaesthesia and analgesia.
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Int J Obstet Anesth · Jul 1996
Carotid artery puncture, airway obstruction and the laryngeal mask airway in a preeclamptic patient.
We report a case of a preeclamptic patient with a difficult airway in whom attempted central venous cannulation led to inadvertent carotid artery puncture and dilatation causing immediate life threatening upper airway obstruction. The use of the laryngeal mask airway was life-saving on two occasions when other techniques of airway management had failed. We discuss the series of events that led to this critical incident and suggest areas in which management might have been improved.
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Int J Obstet Anesth · Jul 1996
The anaesthetic management of intracranial haemorrhage from arteriovenous malformations during pregnancy: three cases.
We report three cases of intracranial haemorrhage from arteriovenous malformations during pregnancy. The anaesthetic management of the pregnant patient undergoing a major neurosurgical procedure and the anaesthetic management of caesarean section in a patient at risk of recurrent intracranial haemorrhage are discussed.