International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2013
ReviewInteractive technology in obstetric anaesthesia and analgesia: exploring seamless solutions to jagged problems.
Perioperative care often involves treating rapid changes in a patient's physiological profile that requires timely intervention by anaesthetists. Interactive technology and closed-loop systems are currently developed in obstetric anaesthesia and analgesia for maintaining parameters during caesarean section and epidural analgesia. ⋯ The components of an interactive system such as the input sensor or device, microprocessor-based control unit and the effector are introduced. Developments in continuous, non-invasive blood pressure monitoring, control algorithms and smart pump technology would help to redefine how technology can assist obstetric anaesthetists to provide better care and improve clinical outcomes for pregnant women.
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Int J Obstet Anesth · Nov 2013
Case ReportsAirway obstruction, caesarean section and thyroidectomy.
Airway obstruction in pregnancy is rare. We report the case of a 39-year-old nulliparous woman with a body mass index of 47 kg/m(2) and a large multinodular goitre causing tracheal compression with airway symptoms who declined thyroid surgery until after delivery. However, worsening hypertension precipitated an urgent caesarean section and thyroidectomy at 32 weeks of gestation. ⋯ Caesarean section was performed and a healthy baby delivered followed by a total thyroidectomy. She was extubated, monitored closely for tracheomalacia and cared for postoperatively in the surgical high-dependency unit. This case highlighted a number of challenges managed successfully with a multidisciplinary team.
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Int J Obstet Anesth · Nov 2013
Outcomes of prospectively-collected consecutive cases of antenatal-suspected placenta accreta.
Accurate diagnosis of placenta accreta is tentative before surgery. This study developed a predictive score for antenatal diagnosis of placenta accreta through mathematical modeling using clinical signs. ⋯ Combining diagnostic features associated with placenta accreta through mathematical modeling has better positive predictive value than ultrasound alone.
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Int J Obstet Anesth · Nov 2013
Editorial CommentPlacenta accreta: successful outcome is all in the planning.