African journal of reproductive health
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Afr J Reprod Health · Mar 2019
Feasibility of a Ketamine Anesthesia Package in Support of Obstetric and Gynecologic Procedures in Kenya When No Anesthetist is Available.
The objective was to assess the feasibility and safety of the ̳Every Second Matters for Emergency and Essential Surgery - Ketamine' (ESM-Ketamine) package in support of obstetric and gynecologic emergency and essential surgery when no anesthetist is available. A consecutive case series was conducted in twelve hospitals across five severely resource-limited counties in Kenya. 530 women underwent obstetric or gynecological operative procedures supported by non-anesthetist clinicians using the ESM-Ketamine package between November 1, 2013 and September 30, 2017. Main outcomes included reasons for ESM-Ketamine activations and ketamine-related adverse events. ⋯ Brief oxygen desaturations (<30 seconds) below 92% occurred in 15 (2.8%) cases and 113 (21.3%) were administered diazepam to treat hallucinations or agitation. There were no ketamine-related deaths or injuries. The ESM- Ketamine package appears feasible and safe for use in support of obstetric and gynecologic surgeries when no anesthetist is available.
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Afr J Reprod Health · Dec 2018
ReviewThe Use of Soluble FMS-like Tyrosine Kinase 1/Placental Growth Factor Ratio in the Clinical Management of Pre-eclampsia.
Hypertensive disorders of pregnancy in particular the category preeclampsia (PE), remains a major cause of both maternal and fetal morbidity and mortality. Angiogenic growth factors (PlGF and VEGF) and their tyrosine kinase receptors -1 and 2 (Flt-1 and KDR) are involved in both fetal and placental development. ⋯ The recent prognostic value of the sFlt-1/PlGF ratio has received considerable attention as a risk indicator of preeclampsia development. The aim of this review is to highlight the current advances in the diagnostic utility of the sFlt-1/PlGF ratio with regards to preeclampsia development.