International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 1998
Management of a parturient with an uncorrected atrioventricular canal defect.
A 24-year-old woman at 37 weeks gestation, with an uncorrected atrioventricular canal defect and incipient congestive heart failure is presented. This rare defect is part of the larger group of endocardial cushion defects. ⋯ Her pregnancy was maintained until she developed symptoms of congestive heart failure. We discuss her peripartum management, monitoring and anesthetic choices.
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Day case transvaginal ultrasound-guided needle puncture is currently the method of choice for oocyte retrieval. The risk of morbidity from this procedure increases with sudden patient movement in response to needle manipulation. ⋯ The aim of this pilot study was to establish whether spinal analgesia using a mixture of bupivacaine and fentanyl could be useful in this context. The results identify several advantages of this technique over current clinical practice, and merit further comparative investigation.
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Int J Obstet Anesth · Jul 1998
General anesthesia for cesarean section at a tertiary care hospital 1990-1995: indications and implications.
Complications of general anesthesia for cesarean section remain the leading cause of anesthesia-related maternal mortality. General anesthesia, however, is becoming less popular for obstetric anesthesia, and thus fewer cesarean sections are conducted using this technique. As the number of general anesthesia cases decrease, the number of difficult intubations witnessed and managed by residents decreases. ⋯ Although the incidence of difficult intubations in those years ranged from 16.3% to 1.3%, only one failed intubation with resultant maternal mortality occurred. Few residency programs offer instruction on the difficult airway in the parturient population. Organized airway management programs specifically for the obstetric population may assist efforts to decrease the morbidity and mortality associated with the provision of general anesthesia for cesarean section.
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We report a case of meningitis developing a number of days after a subarachnoid block for caesarean section. No organisms were grown but the clinical picture was suggestive of bacterial meningitis, the clinical course of which had been modified by the administration of antibiotics for presumed wound infection. The possible aetiology is discussed.