International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2020
Observational StudyRelationship between postpartum mood disorder and birth experience: a prospective observational study.
This study aims to investigate the relationship between the birth experience and the risk of developing postpartum depression or post-traumatic stress disorder. ⋯ Depression and post-traumatic stress symptoms either persisted or had new onset at three months postpartum. Mental health screening and postpartum follow-up after six weeks should be considered in high-risk patients who have a history of psychopathology, nulliparity, or undergo operative management of postpartum hemorrhage.
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Int J Obstet Anesth · Nov 2020
Case ReportsSpiral electrode for continuous fetal heart rate monitoring during in-utero myelomeningocele repair.
Continuous fetal hemodynamic monitoring during in-utero surgery is desirable, but it is often not feasible without intermittent interruption. We report the use of a fetal spiral electrode for continuous heart rate monitoring during fetal myelomeningocele repair. ⋯ Using the Bland-Altman approach, the mean (SD) difference between measurements was 1.8 (3.5) beats per minute with limits of agreement of -5.3 to 8.8 beats per minute. This case illuminates a potential role for a fetal spiral electrode as a real-time adjunct in fetal interventions.
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Int J Obstet Anesth · Nov 2020
Case ReportsPlatypnea-orthodeoxia syndrome: an unusual cause of breathlessness in late pregnancy.
A pregnant patient with shortness of breath and arterial oxygen desaturation is presented. The primary and tentative initial diagnosis was pulmonary embolism. ⋯ Shunting was minimal in the supine and maximal in the upright position, leading to the diagnosis of platypnea-orthodeoxia syndrome. By two weeks postpartum the patient's symptoms had resolved and shunting was undetectable.
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Int J Obstet Anesth · Nov 2020
Case ReportsTonic-clonic seizure after unrecognized unintentional dural puncture.
Patients who suffer an unintentional dural puncture have a high risk of developing a post-dural puncture headache. Other neurologic complications have been reported, but seizure is rarely seen. ⋯ Two epidural blood patches, performed by neuroradiologists, were needed before the patient experienced complete resolution of her headache. During the re-admission, she also experienced a pulmonary embolus which further lengthened her hospital stay.