International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2020
ReviewNovel coronavirus SARS-CoV-2 and COVID-19. Practice recommendations for obstetric anaesthesia: what we have learned thus far.
SARS-CoV-2 is a novel coronavirus causing a global pandemic of a severe respiratory illness known as COVID-19. To date, globally, over 30,000 people have died from this emerging disease. As clinicians and healthcare systems around the world are rapidly adapting to manage patients with COVID-19, limited data are emerging from different patient populations to support best-practice and improve outcomes. In this review, we present a summary of emerging data in the obstetric population and offer obstetric and anaesthetic clinicians around the world a set of evidence-driven, practice-based recommendations for the anaesthetic management of pregnant women with suspected or confirmed COVID-19.
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Int J Obstet Anesth · Aug 2020
Post-traumatic stress disorder and postpartum depression and their reported association with recent labor and delivery: a questionnaire survey cohort.
We aimed to investigate the index traumatic event associated with post-traumatic stress disorder (PTSD) and evaluate the timing of the onset of symptoms in relation to the recent delivery. ⋯ PTSD identified postpartum may not be linked to the recent delivery and often pre-dates it. Future studies should identify the trigger traumatic event responsible for PTSD symptoms, to enable a more accurate picture of the reasons for PTSD and fear of childbirth.
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Int J Obstet Anesth · Aug 2020
Observational StudyHand placement during chest compressions in parturients: a pilot study to identify the location of the left ventricle using transthoracic echocardiography.
Current guidelines for maternal cardiopulmonary resuscitation recommend the hands be placed on the lower half of the sternum for compressions. We sought to evaluate the effect of the gravid uterus and left uterine displacement on the position of the left ventricle (LV) using transthoracic echocardiography. ⋯ This pilot study used transthoracic echocardiography to document the position of the LV during the third trimester of pregnancy. The LV was located approximately 6 cm cranial to the distal tip of the xiphoid process. Further validation is required before recommending changes in hand placement during maternal cardiopulmonary resuscitation.
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Int J Obstet Anesth · Aug 2020
Considerations and strategies in the organisation of obstetric anaesthesia care during the 2019 COVID-19 outbreak in Singapore.
The provision of safe obstetric anaesthesia services is essential during the COVID-19 global outbreak. The identification of the 'high-infection risk' parturient can be challenging especially with the rapidly changing risk criteria for COVID-19 'cases'. ⋯ A constant review of such processes is needed to enhance efficiency and to optimise use of finite resources. Good communication between health officials, institutional leadership and ground staff is essential for the dissemination of information.
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Int J Obstet Anesth · Aug 2020
Maternal and procedural factors associated with estimated blood loss in second trimester surgical uterine evacuation: a retrospective cohort analysis.
Prior studies examining bleeding with uterine evacuation have focused on high-volume centers performing over 1100 procedures annually. The aim of this study was to examine associations between blood loss and patient and procedural characteristics in a center performing fewer than 50 procedures annually. ⋯ While blood loss may be greater in low volume centers, our transfusion and re-admission rates were low following second trimester uterine evacuation.