International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2008
Case ReportsAnaesthetic management of an obstetric patient with Pompe disease.
Pompe disease (Glycogen storage disease type II) leads to abnormal glycogen deposition in various vital organs resulting in multiple systemic sequelae. We present the anaesthetic management for caesarean section of a 31-year-old parturient with known Pompe disease. ⋯ She underwent urgent caesarean section under regional anaesthesia resulting in the birth of a healthy baby girl. To our knowledge, this is the first reported case of both spinal anaesthesia for caesarean section and successful live birth in a patient with Pompe disease.
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Int J Obstet Anesth · Apr 2008
Maternal expectations and birth-related experiences: a survey of pregnant women of mixed parity from Calcutta, India.
In India, as in other parts of the world with high birthrates, there is an imbalance between maternal expectations and provision of labor pain services. Maternal experience may have an impact on attitudes toward the mode of future deliveries and on cesarean section rates. Maternal expectations regarding labor and delivery, and attitudes towards cesarean section were assessed in women of mixed parity during an antenatal visit at a charitable non-governmental hospital in Calcutta. ⋯ This study indicates that information on what to expect during labor and delivery, the potential role of epidural labor analgesia, and the impact of cesarean section on neonatal outcome should be the focus of services instituted to improve antenatal and perinatal care.
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Int J Obstet Anesth · Apr 2008
Case ReportsInfective endocarditis complicated by rupture of intracranial mycotic aneurysm during pregnancy.
We report a case of a pregnant woman who developed infective endocarditis further complicated by an intracranial mycotic aneurysm. She presented with massive intracranial haemorrhage in the third trimester of pregnancy. The disease process of infective endocarditis and peri-operative management of ruptured intracranial mycotic aneurysm during pregnancy are discussed.
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Int J Obstet Anesth · Apr 2008
Acute normovolemic hemodilution, intraoperative cell salvage and PulseCO hemodynamic monitoring in a Jehovah's Witness with placenta percreta.
A Jehovah's Witness who had had four previous cesarean deliveries was referred to our institution for management of a complete placenta previa at 34 weeks of gestation. A subsequent ultrasound scan was suggestive of placenta percreta with bladder involvement. After erythropoietin and iron supplementation, cesarean hysterectomy was performed. ⋯ A bolus of oxytocin given after delivery produced profound hypotension, the hemodynamics of which were elucidated with the PulseCO system. To our knowledge, the combined use of acute normovolemic hemodilution, intraoperative cell salvage and PulseCO hemodynamic monitoring for cesarean hysterectomy has not been reported previously. These techniques may be particularly useful in managing patients who refuse blood products and/or in whom the baseline hemoglobin is suboptimal.