International journal of obstetric anesthesia
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Obesity in pregnant women is a serious health issue. Invasive monitoring devices are rarely used in pregnancy due to their risks; however, assessment of cardiac function is often required in these women. Transthoracic echocardiography offers advantages but may be technically difficult to perform. Our aim was to determine the feasibility of transthoracic echocardiography and to quantify left ventricular function and structure using transthoracic echocardiography in obese pregnant women. ⋯ Transthoracic echocardiography was used to delineate haemodynamics in obese pregnant women. Mean arterial blood pressure and left ventricular mass were increased in obese pregnant woman. The incidence of diastolic impairment and reduced myocardial performance were similar between groups.
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We report the case of a 37-year-old postpartum patient who developed a contained subacute spinal subdural hematoma causing mass effect on the cauda equina and severe spinal stenosis after undergoing an epidural blood patch for postdural puncture headache. Recovery occurred following administration of oral steroids.
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Int J Obstet Anesth · Apr 2012
Case ReportsAnesthetic management of a spontaneous spinal-epidural hematoma during pregnancy.
Spontaneous spinal-epidural hematoma is uncommon and rare during pregnancy. We were presented with a 31-year-old patient who developed back pain with lower extremity paralysis at 36 weeks of gestation. ⋯ Postoperatively, dopamine was infused to maintain the blood pressure within the high-normal range to optimize spinal cord perfusion. Successful anesthetic and postoperative management is described together with a review of the literature.
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Int J Obstet Anesth · Apr 2012
Measurement of intra-abdominal pressure in term pregnancy: a pilot study.
This study was conducted to assess the feasibility of measuring intra-abdominal pressure in term parturients under spinal anesthesia. ⋯ Under spinal anesthesia, intra-abdominal pressure in >25% of healthy term parturients was > 12 mmHg, which has conventionally been defined as intra-abdominal hypertension. The intra-abdominal pressure in term pregnancy should be performed in the left lateral tilt position to avoid falsely elevated pressure measurements.