International journal of obstetric anesthesia
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Int J Obstet Anesth · Feb 2021
Creating a model to predict time intervals from induction of labor to induction of anesthesia and delivery coordinate workload.
Induction of labor continues to become more common. We analyzed induction of labor and timing of obstetric and anesthesia work to create a model to predict the induction-anesthesia interval and the induction-delivery interval in order to co-ordinate workload to occur when staff are most available. ⋯ Time to obstetric and anesthesia tasks can be estimated to optimize induction of labor start times, and shift anesthesia and delivery workload to hours when staff are most available.
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Int J Obstet Anesth · Feb 2021
Observational StudyThe association of shock index and haemoglobin variation with postpartum haemorrhage after vaginal delivery: a prospective cohort pilot study.
Shock index and continuous non-invasive haemoglobin monitoring (SpHb) have both been proposed for the timely recognition of postpartum haemorrhage (PPH). We sought to determine, in parallel, the association of each of shock index and SpHb with blood loss after vaginal delivery. ⋯ The trend of shock index and its peak values are associated with blood loss after vaginal delivery and are early indicators of PPH. Negative trend of SpHb is a late sign of PPH and has a weaker association with blood loss than shock index.
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Int J Obstet Anesth · Feb 2021
Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry.
In South Africa, hypertensive disorders of pregnancy are the leading cause of maternal mortality. More than 50% of anaesthesia-related maternal deaths are attributed to complications of airway management. We compared the prevalence and risk factors for hypoxaemia during induction of general anaesthesia in parturients with and without hypertensive disorders of pregnancy. We hypothesised that hypertensive disorders of pregnancy are associated with desaturation during tracheal intubation. ⋯ Clinically significant oxygen desaturation during airway management occurred twice as often in patients with hypertensive disorders of pregnancy, compounded by increasing body mass index. Intermediary factors in the pathway from hypertension to hypoxaemia were also identified.
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Int J Obstet Anesth · Feb 2021
Obstructive sleep apnea is associated with adverse maternal outcomes using a United States multistate database cohort, 2007-2014.
Obstructive sleep apnea affects approximately 11% of women of reproductive age, although it is often undetected and untreated. Previous studies suggest an association between obstructive sleep apnea and adverse maternal outcomes. Herein, we aim to better characterize the relationship between obstructive sleep apnea and maternal outcomes. ⋯ Pregnant women with obstructive sleep apnea have a significantly higher adjusted risk of adverse maternal outcomes compared with women without obstructive sleep apnea.