International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2014
The relationship between body mass index and post-dural puncture headache in obstetric patients.
Difficult epidural insertion and accidental dural puncture are more likely in the obese pregnant population. Low-level evidence suggests that the risk of post-dural puncture headache declines as body mass index increases. ⋯ This retrospective study found no evidence that women of higher body mass index are less likely to develop a post-dural puncture headache or that the characteristics of the headache and use of epidural blood patch were different.
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It is unclear whether antenatal fibrinogen concentrations are associated with postpartum haemorrhage. ⋯ Antenatal fibrinogen concentration <3.3g/L may be a risk factor for postpartum haemorrhage among women following vaginal delivery.
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Int J Obstet Anesth · Nov 2014
Role of pleth variability index for predicting hypotension after spinal anesthesia for cesarean section.
Hypotension is frequently observed after spinal anesthesia for cesarean section and can be detrimental to both mother and baby. We investigated the role of the pleth variability index for predicting hypotension after spinal anesthesia for cesarean section. ⋯ Greater baseline pleth variability index was associated with hypotension after spinal anesthesia for cesarean section, but may not be a clinically useful predictor.
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Int J Obstet Anesth · Nov 2014
Repeated simulation-based training for performing general anesthesia for emergency cesarean delivery: long-term retention and recurring mistakes.
The percentage of women undergoing cesarean delivery under general anesthesia has significantly decreased, which limits training opportunities for its safe administration. The purpose of this study was to evaluate how effective simulation-based training was in the learning and long-term retention of skills to perform general anesthesia for an emergent cesarean delivery. ⋯ Following lectures and simulation-enhanced training, anesthesia residents reached and retained for up to eight months a competency level in a simulator comparable to that of obstetric anesthesia attending physicians. Errors in performance and missed tasks may be used to improve residency training and continuing medical education.