Preoperative pregnancy testing in surgical patients: How useful is policy of routine testing

Sukhyanti Kerai, Kirti Nath Saxena, Bharti WadhwaIndian Journal of Anaesthesia 2019 63(10):786-790 Surgery in a patient with unrecognised pregnancy has serious ethical and medicolegal implications. There are no guidelines in India for preoperative pregnancy testing (POPT) in surgical patients. This review was undertaken to ascertain utility of routine POPT and whether any specific indication for POPT could be suggested. We performed a literature search to identify publications pertaining to POPT in surgical patients. Searches included PubMed, Google Scholar and internet search for national guidelines. Studies pertaining to incidence of unrecognised pregnancy, cost-effectiveness of POPT, effect of surgery and anaesthesia on pregnancy are included. We excluded articles which were available in languages other than English and those whose full texts were unavailable. Most of the literature about reproductive outcomes after anaesthesia exposure is based on old data. The evidence for teratogenic effect of anaesthetic drugs on human foetus is still inconclusive. Apart from anaesthesia and surgery, the outcome after surgery in unrecognised pregnant patient depends on other factors such as indication for surgery, high incidence of foetal loss in early pregnancy, stress and lifestyle of patient. As it is difficult to unsnarl the effect of these factors, POPT should be offered to all patients who based on history could be possibly pregnant. The cost-effectiveness of POPT appears doubtf...
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research

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RETROSPECTIVE EVALUATION OF ANESTHETIC TECHNIQUES IN PREGNANT WOMEN WITH RENAL TRANSPLANTATION. Turk J Med Sci. 2019 Oct 27;: Authors: Sargin A, Karaman S, Ceylan Ari Ş, Akdemir A, Hortu I Abstract OOBJECTIVE: The aim of this study was to evaluate anesthesia management in cesarean operation of pregnant women undergone renal transplantation and their effects on postoperative renal function retrospectively. MATERIALS-METHODS: After obtaining the approval of the ethics committee of our hospital, the records of pregnant women who underwent kidney transplantation and cesarean section between 2007 and 2...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
The clinical outcome study of dysferlinopathy (COS) is an international natural history study that recruited 197 patients with genetically confirmed dysferlinopathy. In the study 11 women reported a pregnancy in the last 12 months prior to or during the study. A total of 16 pregnancies with 10 live deliveries and 6 miscarriages were recorded at study visits. Delivery was by C-section with regional anaesthesia in half of cases. There were no major delivery problems or medical concerns with the neonates.
Source: Neuromuscular Disorders - Category: Neurology Authors: Source Type: research
This report detailed the first reported case of a successful livebirth following a uterus transplant from a deceased donor.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Case Reports Source Type: research
Publication date: Available online 19 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Emma Sharkey, Siân GriffithsAbstractAnaesthesia, surgery and ionizing radiation may all prove harmful to an undetected pregnancy. Elective procedures should be deferred at least until the second trimester to reduce the risk of teratogenicity or spontaneous abortion. If surgery cannot be delayed, anaesthetic or surgical techniques can be modified, and the use of intraoperative ionizing radiation avoided where possible. Determination of pregnancy status is mandated by current national guidelines prior to any proc...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
ConclusionConception and safe, full-term pregnancy is achievable following Lap-RFA of symptomatic fibroids. Additional large, rigorous, multivariate prospective studies that adjust for confounders and report pregnancy outcomes following symptomatic fibroid treatment are needed.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
This study aimed to determine whether the use of NSAIDs during pregnancy is associated with the risk of miscarriage by using a natural indication-control cohort of pregnant women using acetaminophen rather than NSAIDs.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mother, Fetus, Neonate Source Type: research
Introduction: The National Institute for Health and Clinical Excellence advises women diagnosed with miscarriage should be offered, where appropriate, all three management options: expectant, medical and surgical (which includes surgical management of miscarriage under general anaesthetic [SMM]). Women who opt for surgery often expedite the miscarriage process for physical, social, and psychological reasons. Currently there is no standard for the maximum time a woman should need to wait for her preferred SMM option.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Session 22 – Early Pregnancy, intrauterine insemination and PCOS Source Type: research
(N Engl J Med. 2018;378:2161–2170) First-trimester miscarriage, or early pregnancy loss, is the most common complication in pregnancy. It can frequently be identified before onset of symptoms, and many women prefer active management, which provides the ability to have some control over the situation. Current guidelines recommend the use of prostaglandin analogues to expedite the expulsion of nonviable pregnancy tissue, with a standard dose of 800 μg misoprostol administered vaginally. However, misoprostol has low efficacy among women with a closed cervical os. Although mifepristone, a 19-nor steroid, can h...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mechanisms, Equipment, Hazards Source Type: research
Background: Von Willebrand disease (vWD) is the most common inherited bleeding disorder with a reported prevalence of 1% in epidemiological studies and symptomatic prevalence of 1 in 10,000.Pregnancy in vWD is associated with increased bleeding risk particularly postpartum hemorrhage. Treatment options include desmopressin acetate (DDAVP), plasma derived factor concentrates and antifibrinolytic agents. Human Recombinant von Willebrand factor (vWF) (Vonvendi®) has been approved in the United States for on demand treatment and perioperative management of adults with vWD. It has been shown to maintain sustained levels of ...
Source: Blood - Category: Hematology Authors: Tags: 401. Basic Science and Clinical Practice in Blood Transfusion Source Type: research
ConclusionAppropriate management of pregnant women with TA within the framework of antenatal care programs and adopting a multidisciplinary approach are key to ensure successful outcomes.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
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