Articles: outcome.
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Int J Obstet Anesth · Jan 1996
Anesthetic considerations for parturients with primary pulmonary hypertension: review of the literature and clinical presentation.
Primary pulmonary hypertension, though uncommon, is found relatively frequently in women of childbearing age and carries a high peripartum mortality. We present a patient with severe primary pulmonary hypertension who underwent two cesarean sections 3 and 6 years after the diagnosis of primary pulmonary hypertension was made. Epidural anesthesia was provided on both occasions and resulted in a good maternal and fetal outcome. We have reviewed the literature as it relates to the choice of anesthetic technique and maternal outcome in patients with primary pulmonary hypertension.
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Int J Obstet Anesth · Jul 1995
A case of amniotic fluid embolism in a twin pregnancy in the second trimester.
We present a case of amniotic fluid embolism which is unusual in its presentation in the second trimester of a twin pregnancy, and which, after prompt and aggressive management, produced an equally unusual excellent maternal outcome.
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Int J Obstet Anesth · Jul 1995
Transfer of the critically ill obstetric patient: experience of a specialist team and guidelines for the non-specialist.
Transfer of the critically ill obstetric patient between hospitals is increasingly common. The specialist transfer team based at the Western Infirmary Intensive Therapy Unit, Glasgow has transported 60 such patients in the years 1985-1994. Monitoring was by direct arterial pressure measurement in 56 patients and central venous pressure measurement in 45. ⋯ The majority of patients had pregnancy induced hypertension or had suffered a post partum haemorrhage. A clinical impression that these two groups had different treatment requirements and outcomes was not substantiated. We conclude that the transfer of even the sickest obstetric patient is feasible and safe and suggest guidelines to non-specialists for the management of these patients before and during interhospital transfer.
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Int J Obstet Anesth · Apr 1995
The elective use of oxytocin infusion during labour in nulliparous women using epidural analgesia: a randomised double-blind placebo-controlled trial.
The obstetric outcome following the elective use of oxytocin infusion was determined in a randomised, double-blind placebo-controlled trial. 93 nulliparous women in a London hospital, who had requested epidural analgesia in labour (= 6 cm.), were given an infusion of oxytocin (n = 46) or placebo (n = 47). The initial epidural dose was 15 ml of 0.125% bupivacaine, followed by an infusion at 10 ml per h, with 15 ml top-ups if required. When oxytocin was used electively there was a reduction in the length of the first stage of labour from 696 min to 578 min, (P < 0.05) even though more than half of the control group (53%) required oxytocin augmentation. ⋯ There were no adverse effects on the fetus, as judged by cord pH measurement, Apgar score, admission to the special care baby unit and neonatal jaundice. The prophylactic use of oxytocin in nulliparous women with epidurals reduces the length of the first stage of labour and appears to be safe. It does not reduce the operative delivery rate.
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Unilateral oval pupil has numerous causes, and several pathophysiologic mechanisms have been proposed. Prognosis is nearly universally poor. ⋯ Both patients recovered. The prognosis for comatose patients with unilateral oval pupil is not universally poor.