International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2009
Retrospective analysis of transfusion outcomes in pregnant patients at a tertiary obstetric center.
The decision to use red blood cell transfusion and/or blood products (fresh frozen plasma, platelets, cryoprecipitate) to manage obstetric hemorrhage or treat postpartum anemia is often made empirically by physicians. We performed a retrospective study to review transfusion outcomes in pregnant and postpartum patients at a large obstetric center. ⋯ More formal assessment and documentation of the etiologic factors associated with transfusion management in pregnant patients is advised. In addition, the identification and management of undetected postpartum anemia is underappreciated.
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Int J Obstet Anesth · Oct 2009
Randomized Controlled Trial Comparative StudyA randomized controlled study of whether the partner's presence in the operating room during neuraxial anesthesia for cesarean delivery reduces patient anxiety.
This study compared anxiety in two groups of women undergoing elective cesarean delivery to ascertain if their partner's presence during neuraxial anesthesia placement affected patients' overall anxiety levels. ⋯ Although patients whose partners were present in the operating room at the time of neuraxial anesthesia placement reported less anxiety over the time of the study than did patients whose partners were not present, these differences were small and are not considered to be clinically important. Increased anxiety among partners who were not present at neuraxial placements warrants further study.
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Int J Obstet Anesth · Oct 2009
Randomized Controlled TrialA randomized controlled trial of the effect of combined spinal-epidural analgesia on the success of external cephalic version for breech presentation.
Improving the success of external cephalic version (ECV) for breech presentation may help avoid some cesarean deliveries. The results of randomized trials comparing the success of ECV with neuraxial analgesia compared to control are inconsistent. We hypothesized that combined spinal-epidural (CSE) analgesia would increase the success of ECV when compared with systemic opioid analgesia. ⋯ There was no difference in the rate of successful ECV or vaginal delivery with CSE compared to intravenous fentanyl analgesia. Pain scores were lower and satisfaction higher with CSE analgesia, and median time to fetal heart rate reactivity was shorter in the CSE group.