International journal of obstetric anesthesia
-
Int J Obstet Anesth · Jul 1998
Management of a parturient with an uncorrected atrioventricular canal defect.
A 24-year-old woman at 37 weeks gestation, with an uncorrected atrioventricular canal defect and incipient congestive heart failure is presented. This rare defect is part of the larger group of endocardial cushion defects. ⋯ Her pregnancy was maintained until she developed symptoms of congestive heart failure. We discuss her peripartum management, monitoring and anesthetic choices.
-
Int J Obstet Anesth · Jul 1998
Anaesthetic management of vaginal delivery in a woman with Friedreich's ataxia complicated by cardiomyopathy and scoliosis.
We report the anaesthetic management of vaginal delivery in a woman with Friedreich's ataxia, who had hypertrophic cardiomyopathy and had previously undergone thoracic spinal fusion with Harrington rod fixation. Combined spinal-epidural analgesia was used. Options for the anaesthetic management of labour and delivery are discussed.
-
Int J Obstet Anesth · Jul 1998
Epidural analgesia for term vaginal delivery after balloon valvotomy for mitral stenosis at 24 weeks gestation.
A woman presented at 24 weeks gestation with previously undiagnosed mitral stenosis. She did not respond to conservative management and underwent successful percutaneous balloon mitral valvotomy for refractory congestive cardiac failure, with complete resolution of her symptoms. The remainder of her pregnancy was uncomplicated and she delivered a healthy infant at 39 weeks gestation. An epidural block provided analgesia/anesthesia for vaginal delivery and repair of the perineal tear.
-
Day case transvaginal ultrasound-guided needle puncture is currently the method of choice for oocyte retrieval. The risk of morbidity from this procedure increases with sudden patient movement in response to needle manipulation. ⋯ The aim of this pilot study was to establish whether spinal analgesia using a mixture of bupivacaine and fentanyl could be useful in this context. The results identify several advantages of this technique over current clinical practice, and merit further comparative investigation.