American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jun 1985
Evaluation of the use of continuous lumbar epidural anesthesia for hypertensive pregnant women in labor.
The use of continuous lumbar epidural anesthesia in women with pregnancy-induced hypertension remains controversial. We retrospectively reviewed the charts of 285 women with pregnancy-induced hypertension who were delivered in a 2-year period. Among 185 vaginally delivered patients who received continuous lumbar epidural or local anesthesia, there were no significant differences in the incidence of maternal hypotension, abnormal fetal heart rate tracings, low Apgar scores, or neonatal intensive care unit admissions. ⋯ However, general anesthesia patients were more likely to have abnormal fetal heart rate tracings (27% versus 4%) requiring urgent delivery. Thus differences in outcome probably reflect poorer fetal condition prior to anesthesia induction rather than a specific anesthetic effect. These results demonstrate that continuous lumbar epidural anesthesia is safe and effective for both the fetus and the mother with pregnancy-induced hypertension.
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Am. J. Obstet. Gynecol. · Jun 1985
Experience with the pulmonary artery catheter in obstetrics and gynecology.
Although traditionally the exclusive domain of other medical specialties, pulmonary artery catheterization may be of tremendous benefit to a variety of obstetric and gynecologic patients. Our experience with such invasive hemodynamic monitoring in 72 patients in an obstetrics and gynecology service is presented. ⋯ On the basis of our experience, recommended indications for pulmonary artery catheterization in obstetric and gynecologic patients are presented. Insertion techniques, complications, and clinical outcome are discussed.
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Am. J. Obstet. Gynecol. · Jun 1985
Hemodynamic observations in severe preeclampsia complicated by pulmonary edema.
Ten patients with severe preeclampsia complicated by pulmonary edema were studied with invasive hemodynamic monitoring. Eight of 10 patients developed pulmonary edema during the postpartum period. ⋯ Two patients had evidence of left ventricular failure. In three of the patients, the central venous pressure was significantly lower than the simultaneously determined pulmonary artery wedge pressure during the acute phase of the pulmonary edema.