International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2006
Case ReportsA case of sciatic neuropathy after caesarean section under spinal anaesthesia.
We present a rare case in which a healthy parturient developed a left sciatic neuropathy after spinal anaesthesia for caesarean section. Intraoperatively, a wedge was placed under her right buttock to tilt the pelvis and uterus to the left, to minimise aortocaval compression. Postoperatively, she complained of being unable to move her left foot. ⋯ Seven weeks after surgery the patient had made a full recovery. We conclude that the prolonged lateral tilt position might cause compression neuropathy of the sciatic nerve. After childbirth, re-positioning the patient supine or shortening the time of lateral tilt may reduce the risk of sciatic nerve injury.
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Int J Obstet Anesth · Oct 2006
Case ReportsCardiorespiratory symptoms during pregnancy--not always pulmonary embolism.
We describe a case of sudden onset severe cardiorespiratory compromise in a parturient at 36 weeks' gestation. She received treatment for infection, pulmonary oedema and pulmonary embolism before a diagnosis of aortic dissection was made. ⋯ We discuss the difficulties of diagnosis of cardiorespiratory symptoms and the potential hazards of instituting therapy before a definitive diagnosis is reached. The value of a multidisciplinary team approach and the use of portable echocardiography in the investigation of both pulmonary embolism and cardiac disease are emphasised.