International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2017
Randomized Controlled TrialSafety and effectiveness of alveolar recruitment maneuvers and positive end-expiratory pressure during general anesthesia for cesarean section: a prospective, randomized trial.
During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. ⋯ Compared to standard care, the alveolar recruitment maneuver with positive end-expiratory pressure and low tidal volumes appears safe and effective in improving lung compliance and both intraoperative and postoperative oxygenation in women undergoing general anesthesia for elective cesarean section.
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Int J Obstet Anesth · May 2017
Observational StudyImmediate postpartum neurological deficits in the lower extremity: a prospective observational study.
Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. ⋯ Transient neurological complications after labour and delivery are infrequent, mainly sensory involving multiple lumbosacral nerve roots or specific sacral cutaneous nerves, and they typically resolve within a short time.
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Int J Obstet Anesth · May 2017
Lessons learned from a single institution's retrospective analysis of emergent cesarean delivery following external cephalic version with and without neuraxial anesthesia.
To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. ⋯ In this single hospital's practice, patients who may be at higher risk of complications and have a lesser likelihood of success were provided NA for ECV. As a result, the use of neuraxial anesthesia for external cephalic version was associated with a higher rate of emergent cesarean delivery. Obstetric and anesthetic practices should evaluate their patient selection and procedure protocol for external cephalic version under neuraxial anesthesia.
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Int J Obstet Anesth · May 2017
Obstetric interventions and maternal morbidity among women who experience severe postpartum hemorrhage during cesarean delivery.
Compared to vaginal delivery, women undergoing cesarean delivery are at increased risk of postpartum hemorrhage. Management approaches may differ between those undergoing prelabor cesarean delivery compared to intrapartum cesarean delivery. We examined surgical interventions, blood component use, and maternal outcomes among those experiencing severe postpartum hemorrhage within the two distinct cesarean delivery cohorts. ⋯ Our findings provide a snapshot of contemporary transfusion and surgical practices for severe postpartum hemorrhage management during cesarean delivery. To determine optimal transfusion and management practices in this setting, large pragmatic studies are needed.
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Int J Obstet Anesth · May 2017
What's trending now? An analysis of trends in internet searches for labor epidurals.
The study aim was to investigate internet use for obtaining information about epidurals for labor and delivery. ⋯ The findings provide an insight into internet use by those seeking information about labor analgesic options. Identifying the most common and rapidly increasing online search queries may guide physician-parturient interactions and online content creation, to address labor analgesic topics that most interest users.