International journal of obstetric anesthesia
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Int J Obstet Anesth · Feb 2019
ReviewWhat's New in Obstetric Anesthesia: a focus on maternal morbidity and mortality.
The Ostheimer lecture is given each year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. It summarizes "What's New in Obstetric Anesthesia" based on a systematic evaluation of the relevant literature published in the previous calendar year. In this review I consider studies published in 2016 focused on the prevalence of, and risk factors for, maternal morbidity and mortality. I also discuss novel therapeutic approaches to the prevention and treatment of major sources of maternal morbidity and mortality.
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Int J Obstet Anesth · Feb 2019
Review Comparative StudyIs training in obstetric critical care adequate? An international comparison.
Obstetric critical care is an emerging discipline which cuts across speciality boundaries. We have analysed the training curricula in the three major specialities (obstetrics, anaesthesia and intensive care medicine) likely to be involved in the care of the critically-ill obstetric patient, to assess whether it is adequate to ensure effective training on this subject.
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Int J Obstet Anesth · Feb 2019
Randomized Controlled TrialProphylactic infusion of phenylephrine is effective in attenuating the decrease in regional cerebral blood volume and oxygenation during spinal anesthesia for cesarean section.
Hypotension induced by spinal anesthesia for cesarean section causes a decrease in maternal regional cerebral blood volume and oxygenation. We used near-infrared spectroscopy to determine whether prophylactic infusion of phenylephrine attenuates these decreases. ⋯ Prophylactic infusion of phenylephrine, especially at 25 µg/min, can effectively suppress decreases in regional cerebral blood volume and regional cerebral blood oxygenation after induction of spinal anesthesia for cesarean section.
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Int J Obstet Anesth · Feb 2019
Case ReportsAnaesthetic implications of a patient with cold-induced anaphylaxis presenting to the labour ward.
Cold contact urticaria is a well described condition, with reactions ranging from localised wheals to systemic and anaphylactic reactions. Case reports involving anaesthetic care are rare. ⋯ She subsequently had an uneventful instrumental delivery following an epidural 'top-up'. This report focuses on the anaesthetic implications of her condition.