International journal of obstetric anesthesia
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Int J Obstet Anesth · Sep 2024
LetterObstetric hemorrhage risk assessment using the maximum allowable blood loss calculation: are we on the right track?
The clinical guidelines on postpartum hemorrhage from the Society of Obstetricians and Gynaecologists of Canada (SOGC) provide evidence-based recommendations structured around the 6Rs framework: Risk Assessment, Risk Reduction, Recognition and Evaluation, Reaction, Resuscitation, and Review. Since its publication, our institution has begun implementing all the guideline recommendations. ⋯ However, there is currently a lack of evidence supporting the use of MABL calculation in the obstetric population. In this commentary, we highlight the limitations of the MABL calculation through specific examples and propose areas for further research.
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Int J Obstet Anesth · Sep 2024
ReviewAnaesthetic considerations for impacted fetal head at caesarean delivery: a focused review.
Impacted fetal head occurs when the fetal head is deeply engaged within the maternal pelvis and difficult to deliver during caesarean delivery. In order to deliver the fetal head, additional surgical manoeuvres and/or pharmacological tocolysis are needed. The aim of this focused review is to outline the incidence, risk factors, management and complications of this obstetric emergency from the perspective of the anaesthetist. ⋯ Impacted fetal head is an obstetric emergency that the anaesthetist should be familiar with and has a vital role in managing. We propose an algorithm for management that may serve as a clinical decision aid.
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Int J Obstet Anesth · Sep 2024
Impact of an interdisciplinary process to increase utilization of neuraxial anesthesia for cesarean delivery: A retrospective database analysis.
Neuraxial anesthesia is the preferred anesthesia mode for cesarean delivery (CD). The primary study aim was to study the rate of neuraxial anesthesia for cesarean delivery before and after educational strategies were implemented, focusing on neuraxial anesthesia use for CD. ⋯ This study demonstrates the utility of educational strategies to increase neuraxial anesthesia use and highlights the importance of proactive interdisciplinary labor management.