International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2024
Labor epidural analgesia among Han and Uyghur parturients: a prospective observational study in China.
Disparities in pain sensitivity and tolerance have been described, however little is known about variability in the experience of labor pain and childbirth in China. ⋯ Our findings suggest that Uyghur women experience labor pain with higher levels of pain and with higher use of epidural analgesics than Han women. Further studies are needed to evaluate whether these differences are clinically relevant.
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Int J Obstet Anesth · Nov 2024
ReviewResuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a strategy for postpartum haemorrhage management: A narrative review.
Postpartum hemorrhage (PPH) remains one of the leading causes of maternal mortality worldwide, with a significant impact on global health. Optimal management of PPH involves distinct steps executed simultaneously by a multidisciplinary approach, with anesthesiologists playing a key role in hemodynamic control and patient resuscitation. In this context, an aortic blood flow interruption through an internal balloon should be considered a rescue option among the various opportunities, to treat or prevent abdominal hemorrhages. ⋯ At the same time, challenges such as the need for skilled operators, potential complications, costs, and the consideration of fetal safety were also discussed. REBOA presents as a promising tool against PPH, with efficacy in reducing blood loss, preserving fertility, and potentially decreasing maternal mortality and improving outcomes. However, its implementation requires careful consideration, training, and further research to establish clear guidelines for its use in obstetric care.
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Int J Obstet Anesth · Nov 2024
Upper back, neck, and shoulder pain during labor epidural analgesia: a quality improvement initiative.
Severe upper back/interscapular, neck and shoulder pain during labor epidural analgesia (PLEA) is not uncommon. The objective of this quality initiative was to evaluate the incidence, demographic associations and management of PLEA. ⋯ The incidence of PLEA was higher than previously reported. Patients with PLEA were younger, more commonly nulliparous, had higher BMI, longer epidural infusion times and higher CD rates. A three-step treatment protocol was successful in managing PLEA.