International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2011
Case ReportsMultiple complications following the use of prophylactic internal iliac artery balloon catheterisation in a patient with placenta percreta.
The incidence of placenta praevia/accreta is increasing, placing women at significant risk of postpartum haemorrhage with associated morbidity and mortality. National guidelines recommend prophylactic placement of internal iliac artery balloon occlusion catheters for women with abnormal placentation. ⋯ She developed bilateral pseudoaneurysms, unilateral arterial rupture and compromised vascular supply to her right leg secondary to thrombus formation, and suffered massive haemorrhage, both despite and as a result of intervention. This is the first case report of multiple complications in an obstetric patient after temporary internal iliac balloon occlusion in an elective setting.
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Int J Obstet Anesth · Jan 2011
Case ReportsAnesthetic management of a parturient with type III Klippel-Feil syndrome.
Klippel-Feil syndrome is believed to occur from failure of normal segmentation of cervical somites during gestation. We present the case of a 38-year-old primiparous woman with type III Klippel-Feil syndrome for elective cesarean delivery. Our patient had a short webbed neck, short stature, limited neck flexion and extension, and thoraco-lumbar abnormalities. ⋯ We planned a combined spinal-epidural technique; however, only the epidural technique was obtained. Cesarean delivery was commenced with favorable maternal and fetal outcomes. Post-operative pain management was provided with intravenous morphine patient-controlled analgesia.
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Int J Obstet Anesth · Jan 2011
Letter Case ReportsDangers of rapid oxytocin administration in Eisenmenger's Syndrome.
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Int J Obstet Anesth · Jan 2011
General anesthesia for cesarean delivery at a tertiary care hospital from 2000 to 2005: a retrospective analysis and 10-year update.
Complications from general anesthesia for cesarean delivery are a leading cause of anesthesia-related mortality. As a consequence, the overall use of general anesthesia in this setting is becoming less common. The impact and implications of this trend are considered in relation to a similar study performed at our institution 10 years ago. ⋯ The use of general anesthesia for cesarean delivery is low and declining. These trends may reflect the early and increasing use of neuraxial techniques, particularly in parturients with co-existing morbidities. A significant reduction in exposure of trainees to obstetric general anesthesia has been observed.