International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2018
Experimental validation of the CompuFlo® epidural controlled system to identify the epidural space and its clinical use in difficult obstetric cases.
This prospective study was designed to validate the CompuFlo® device and to assess its use in difficult epidural placement. ⋯ In all cases epidural analgesia was successful and no complications were noted. There was a good correlation between the operator's feelings and the delta of pressure recorded by the CompuFlo®, for both identification of the ligamentum flavum and of the epidural space (Rho = 0.79; tau = 0.67). In the second part of the study, all the difficult blocks performed with the CompuFlo® were successful after a single attempt. The pressure curves of false loss-of-resistance were significantly different from the true loss-of-resistance (P <0.0001) DISCUSSION: CompuFlo® was validated as a tool to identify the epidural space. It may also assist trainees in successful epidural placement in difficult cases.
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Int J Obstet Anesth · Nov 2018
Case ReportsAnesthetic management for cesarean delivery in a patient with uncorrected pulmonary atresia, ventricular septal defect and major aortopulmonary collateral arteries.
Pulmonary atresia witha ventricular septal defect and major aortopulmonary collateral arteries is an extremely rare congenital disorder characterized by a high risk of maternal mortality. We present the case of a 24-year-old primigravid woman with uncorrected pulmonary atresia, ventricular septal defect and major aortopulmonary collateral arterieswho presented at 35+5 weeks' gestation. Based on the pathophysiology of the congenital cardiac lesion, cesarean delivery was performed under epidural anesthesia under management by a multidisciplinary team. This report highlights the anesthesia management of a rare uncorrected congenital cardiac lesion for cesarean delivery.
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Int J Obstet Anesth · Nov 2018
Observational StudyOcular ultrasonography for diagnosing increased intracranial pressure in patients with severe preeclampsia.
Ultrasound measurements of optic nerve sheath diameter (ONSD) and optic disc height (ODH) measured outside pregnancy correlate with intracranial hypertension. Data on the usefulness of ocular ultrasonography in preeclampsia are limited. ⋯ Severe preeclampsia was associated with a significantly higher ONSD and increased ODH, which could be ultrasonographic evidence of papilledema.