International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2009
Letter Case ReportsIntrathecal catheters and epidural blood patching.
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Pulmonary hypertension is defined by a mean pulmonary artery pressure of greater than 25 mmHg at rest or 30 mmHg with exercise. It can occur in association with a variety of medical conditions. The most serious elevation in pulmonary artery pressures are seen in a group of conditions that share the histological entity of plexogenic pulmonary arteriopathy. ⋯ Specific targeted therapy for pulmonary hypertension may be required during pregnancy. Many agents are contraindicated because of risks of teratogenicity or secretion into breast milk. The optimum mode of delivery is not clear but early input from the high-risk obstetric anaesthesia team is essential.
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Int J Obstet Anesth · Apr 2009
Life-saving or ineffective? An observational study of the use of cricoid pressure and maternal outcome in an African setting.
Cricoid pressure is a routine part of rapid-sequence induction of general anaesthesia in obstetrics, but its efficacy in saving life is difficult to ascertain. ⋯ This study does not provide any evidence for a protective effect of cricoid pressure as used in this context, in preventing regurgitation or death. Preoperative gastric emptying may be a more effective measure to prevent aspiration of gastric contents.
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Int J Obstet Anesth · Apr 2009
Introduction of cell salvage to a large obstetric unit: the first six months.
We introduced red-cell salvage to our obstetric unit following a two-month period of training and education. We report a service evaluation of the first six months of activity from May to October 2007. ⋯ We have successfully introduced cell salvage to our unit in a relatively short period of time and have used it for the largest series of patients reported in the UK.