International journal of obstetric anesthesia
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We report a case of a healthy 29-year-old parturient with a normal pre-operative platelet count who received combined spinal-epidural anesthesia for cesarean section, and who suffered the sudden intra-operative onset of severe thrombocytopenia (platelet count 3 × 109/L). This event was likely due to cefoxitin administered for the prophylaxis of surgical infection.
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Int J Obstet Anesth · Feb 2023
Evaluation of ultrasound airway assessment parameters in pregnant patients and their comparison with that of non-pregnant women: a prospective cohort study.
Clinical airway assessment parameters differ significantly between pregnant and non-pregnant patients, however literature comparing their ultrasound (US) airway parameters is limited. We planned a prospective cohort study to compare US-assessed airway parameters between pregnant and non-pregnant women. ⋯ The US airway assessment parameters differ significantly between pregnant and non-pregnant patients. Pregnancy, hyoid bone visibility, and Pre-E/E-VC ratio were independent predictors of the difficult airway in female patients.
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Int J Obstet Anesth · Feb 2023
Case ReportsSuccessful surgical cricothyroidotomy following an obstetric "can't oxygenate" scenario: a narrative of enabling factors.
The airway management of a patient requiring emergency caesarean delivery for fetal distress and pre-eclampsia with severe features is described. A difficult obstetric airway was anticipated prior to induction and managed with the use of decision-support guidelines and cognitive aids. Failed tracheal intubation later progressed to a "can't oxygenate" scenario necessitating front-of-neck-access via surgical cricothyroidotomy. We discuss the factors which facilitated the preparation and implementation of interventions required to successfully execute this high-acuity task.