International journal of obstetric anesthesia
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The current article covers some of the major themes that emerged in 2009 in the fields of obstetric anesthesiology, obstetrics, and perinatology, with a special emphasis on the implications for the obstetric anesthesiologist.
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Int J Obstet Anesth · Apr 2011
ReviewTransthoracic echocardiography in obstetric anaesthesia and obstetric critical illness.
Transthoracic echocardiography (TTE) is a powerful non-invasive diagnostic, monitoring and measurement device in medicine. In addition to cardiologists, many other specialised groups, including emergency and critical care physicians and cardiac anaesthetists, have recognised its ability to provide high quality information and utilise TTE in the care of their patients. In obstetric anaesthesia and management of obstetric critical illness, the favourable characteristics of pregnant women facilitate TTE examination. ⋯ This article outlines the application of TTE in the specialty of obstetric anaesthesia and in the management of obstetric critical illness. It describes the importance of TTE education, quality assurance and outcome recording. It also discusses how barriers to the routine implementation of TTE in obstetric anaesthesia and management of obstetric critical illness can be overcome.
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Int J Obstet Anesth · Apr 2011
Case ReportsAnaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.
We describe the anaesthetic management of a patient with Liddle's syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle's syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. ⋯ Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle's syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.
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Int J Obstet Anesth · Jan 2011
Case ReportsAnesthetic management of a parturient with type III Klippel-Feil syndrome.
Klippel-Feil syndrome is believed to occur from failure of normal segmentation of cervical somites during gestation. We present the case of a 38-year-old primiparous woman with type III Klippel-Feil syndrome for elective cesarean delivery. Our patient had a short webbed neck, short stature, limited neck flexion and extension, and thoraco-lumbar abnormalities. ⋯ We planned a combined spinal-epidural technique; however, only the epidural technique was obtained. Cesarean delivery was commenced with favorable maternal and fetal outcomes. Post-operative pain management was provided with intravenous morphine patient-controlled analgesia.