Predictors of difficult epidural placement in pregnant women: A trainees ' perspective

Conclusion: Inability to palpate the spinous process contributes to multiple attempts at epidural placement when performed by a trainee.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research

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ranke P Abstract In 2019 the annual conference of the scientific working group on obstetric anesthesiology of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) took place in the usual manner. Emergency situations, such as the challenge of a preclinical birth or the recognition and treatment of an amniotic fluid embolism were discussed. In addition, topics on the correct treatment of a female patient with a known addictive disorder were of great interest as well as the discussion on the question when a transfusion should be performed in postpartum anemia and which risks accompany the increasin...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Authors: Taylor CR, Dominguez JE, Habib AS Abstract Obesity is a significant global health problem. It results in a higher incidence of complications for pregnant women and their neonates. Cesarean deliveries are more common in obese parturients as well. The increased burden of comorbidities seen in this population, such as obstructive sleep apnea, necessitates antepartum anesthetic consultation. These patients pose unique challenges for the practicing anesthesiologist and may benefit from optimization prior to delivery. Complications from anesthesia and overall morbidity and mortality are higher in this population...
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
Publication date: Available online 6 November 2019Source: Annals of Medicine and SurgeryAuthor(s): Efrain Riveros-Perez, Sherwin Davoud, Maria Gabriela Sanchez, Hugo Montesinos, Alexander RocutsAbstractIntroductionA common belief has been that obese patients are prone to develop aspiration of gastric contents when general anesthesia is administered. We aimed to determine the correlation between antral cross-sectional area as a surrogate of gastric volume measured by gastric ultrasound, and body mass index (BMI) in term pregnant women scheduled for elective cesarean section.MethodsA cross-sectional observational study was c...
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Guideline No. 392-Pregnancy and Maternal Obesity Part 2: Team Planning for Delivery and Postpartum Care. J Obstet Gynaecol Can. 2019 Nov;41(11):1660-1675 Authors: Maxwell C, Gaudet L, Cassir G, Nowik C, McLeod NL, Jacob CÉ, Walker M Abstract OBJECTIVE: This guideline will review key aspects in the pregnancy care of women with obesity. Part I will focus on Preconception and Pregnancy Care. Part II will focus on Team Planning for Delivery and Postpartum Care. INTENDED USERS: All health care providers (obstetricians, family doctors, midwives, nurses, anaesthesiologists) who provide pregnan...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Authors: Maxwell C, Gaudet L, Cassir G, Nowik C, McLeod NL, Jacob CÉ, Walker M Abstract OBJECTIVE: This guideline will review key aspects in the pregnancy care of women with obesity. Part I will focus on pre-conception and pregnancy care. Part II will focus on team planning for delivery and Postpartum Care. INTENDED USERS: All health care providers (obstetricians, family doctors, midwives, nurses, anaesthesiologists) who provide pregnancy-related care to women with obesity. TARGET POPULATION: Women with obesity who are pregnant or planning pregnancies. EVIDENCE: Literature was retrieved through s...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Conclusions: Multidisciplinary approaches are necessary from obstetricians, cardiologists, anesthesiologists and perinatologists for pregnancy monitoring and delivery outcomes. PMID: 31569595 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Starting the night shift and this case came in 2 hours prior to my arrival: 25 yo G1P0 @ 39 week gestation, BMI 77, 210 kg, admitted for attempted IOL for fetal macrosomia and super morbid obesity. PMH: - Likely OSA, PSG scheduled in 3 weeks. Can lie flat and breathe comfortably if awake but sleeps on side at night due to waking up from obstruction. Worse since pregnancy. - Mild intermittent asthma, uses inhaler 1-2x every 2 weeks. Worse since being pregnant. - Chiari 1 malformation dx'd 2... OB Case
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums
This study evaluated the validity of existing OSA screening tools in a cohort of extremely obese pregnant women [body mass index (BMI) ≥40 kg/m2] and determined what screening factors were most strongly associated with OSA in this cohort.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mechanisms, Equipment, Hazards Source Type: research
(BJOG. 2018;125:1558–1566.) Overweight and obesity represent a significant impact on the world’s public health, and are associated with increased risks of adverse maternal and infant outcomes during pregnancy and delivery. As maternal body mass index (BMI) increases, gestational diabetes mellitus (GDM) also increases in prevalence. GDM is associated with adverse perinatal outcomes similar to those seen in obese pregnant women, including the need for induction of labor and cesarean section, and having an infant born large for gestational age or birthweight over 4 kg. The aim of this secondary analysis fr...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mother, Fetus, Neonate Source Type: research
Publication date: Available online 21 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Naomi Fleming, Rowena CockerhamAbstractGeneral anaesthesia in obstetrics is reducing with a reported use in only 4% of caesarean sections in 2017–2018. Obstetric surgery is often urgent, requiring effective team communication and a rapid, focused preoperative assessment. Physiological changes of pregnancy increase the incidence of aspiration, desaturation and failed intubation. In addition, the rapidly evolving circumstances add additional stress, impacting on performance. Hypotension from aortocaval compr...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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