ASA: Unnecessary Opioids Often Prescribed After C-Section
MONDAY, Oct. 21, 2019 -- Opioids are commonly not needed but are overprescribed at discharge among women who undergo cesarean deliveries (CDs), and provider education and new order sets can reduce use of oxycodone for post-CD pain management,...
There are various complications that can occur in the postpartum period, including pain, bleeding, and infection. These include complications related to cesarean section, postpartum hemorrhage and hematomas, bladder injury, torsion and uterine dehiscence, and rupture. It is important the radiologist is aware of these entities and the associated imaging features to help guide timely and appropriate management.
ConclusionWe report a case of CSP that, following an initial apparently “successful” treatment with methotrexate, required surgical management due to heavy bleeding.
Discussion: Our survey revealed variations in the clinical management of a failed epidural top up for cesarean delivery, suggesting guidelines to aid decision-making are needed. PMID: 31281354 [PubMed]
Conclusions: Abdominal wall endometriosis is the presence of ectopic endometrial tissue in any layer of the abdominal wall. Patients with this diagnosis are referred to the general surgeon presenting a tumor, however, the preoperative diagnosis rate is erroneous in most cases. Abdominal wall ultrasound is useful in diagnosis; tomography and magnetic resonance determine the extent of the disease. The treatment must be related to the extension of the disease and its recurrence is associated with the presence of positive margins. PMID: 31264985 [PubMed - in process]
Rationale: Pain management is an essential part of good obstetrical care. The rapid onset of pain relief after combined spinal-epidural (CSE) analgesia may cause a transient imbalance in maternal catecholamine level, leading to uterine hyperactivity and fetal heart rate (FHR) abnormalities. How to manage the uterine basal tone and FHR abnormalities after labor analgesia still remains controversial. Patient concerns: A 33-year-old nulliparous woman at 40+5 weeks’ gestation underwent induction of labor after premature rupture of membranes. CSE analgesia was provided when the patient described her pain as the top o...
Cesarean section (CS) is one of the most common surgical procedures and postoperative pain control is an important aspect of postoperative management.1 Generally, spinal anesthesia is performed for the peri-operative management of CS. Spinal anesthesia with opioids has gained popularity for postoperative pain relief because it reportedly results in improved analgesia, and ultrasound-guided nerve blocks have also been performed as part of multimodal analgesia after CS.2
SUMMARY An isthmocele, a cesarean scar defect or uterine niche, is any indentation representing myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall, with the base communicating to the uterine cavity, at the site of a previous cesarean section scar. It can be classified as a small or large defect, depending on the wall thickness of the myometrial deficiency. Although usually asymptomatic, its primary symptom is abnormal or postmenstrual bleeding, and chronic pelvic pain may also occur. Infertility, placenta accrete or praevia, scar dehiscence, uterine rupture, and cesarean scar ectopic preg...
Conclusions: Epidural administration of 0.6 mg hydromorphone coadministered with ropivacaine after cesarean section provided satisfactory pain relief with less sulfentanil consumption. This trial is registered with ChiCTR-IPR-16010026. PMID: 30944686 [PubMed - in process]
ConclusionsA suspicious attitude towards cancer-related symptoms during pregnancy is crucial to prevent delayed evaluation for CRC.
Conclusion Hepatic infarction is an extraordinarily rare complication of pre-eclampsia. Early recognition and prompt multidisciplinary management are vital to prevent catastrophic bleeding, hepatic failure, and death. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | open access Full text