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Specialty: Anesthesiology
Condition: Pregnancy

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Total 33 results found since Jan 2013.

The role of intraoperative stroke volume variation on bleeding during functional endoscopic sinus surgery.
CONCLUSIONS: Targeting SVV larger than 12%, achieves a possible reduction of the intraoperative bleeding in patients undergoing FESS. PMID: 29745623 [PubMed - as supplied by publisher]
Source: Minerva Anestesiologica - May 12, 2018 Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research

Puerperium Stroke and Subsequent Tissue-Type Plasminogen Activator–Induced Hemorrhage: A Case Report
We report a case of ischemic stroke in an apparently healthy 35-year-old gravida 2 para 1 who was treated with tissue-type plasminogen activator (tPA) 9 hours after vaginal delivery that resulted in severe hemorrhage. Limited data suggest use of thrombolytics in pregnancy is safe, but there is a paucity of evidence assessing their use immediately postpartum. We describe successful combination of tPA with endovascular mechanical thrombectomy (EMT) for treatment of postpartum stroke, which was followed by extensive uterine bleeding.
Source: A&A Case Reports - May 1, 2021 Category: Anesthesiology Tags: Case Report Source Type: research

A stroke during pregnancy revealing an abdominal aorta coarctation.
PMID: 24560528 [PubMed - as supplied by publisher]
Source: Annales Francaises d'Anesthesie et de Reanimation - February 19, 2014 Category: Anesthesiology Authors: Oudghiri N, Bentalha A, Doumiri M, Tachinante R, Tazi AS Tags: Ann Fr Anesth Reanim Source Type: research

Anesthetic Management of Mitochondrial Encephalopathy With Lactic Acidosis and Stroke-Like Episodes (MELAS Syndrome) in a High-Risk Pregnancy: A Case Report
We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered. This is to our knowledge the first case report of obstetric complications in MELAS syndrome and highlights the salient metabolic sequelae of this syndrome.
Source: A&A Case Reports - July 14, 2017 Category: Anesthesiology Tags: Case Reports: Case Report Source Type: research

Applied cardiovascular physiology
Publication date: Available online 29 March 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Jon Hopper, Carla Gould Maintaining an equilibrium between oxygen supply and demand is a principal function of the cardiovascular system. In times of altered metabolic demand mechanisms exist to maintain the balance between supply and demand. Exercise, haemorrhage and pregnancy all lead to changes in oxygen demand and subsequently modification of cardiac output. The main response to isotonic exercise is an increased cardiac output by autonomically mediated increases in heart rate and venous return. This allo...
Source: Anaesthesia and intensive care medicine - March 28, 2016 Category: Anesthesiology Source Type: research

Cardiac Structure and Function in Morbidly Obese Parturients: An Echocardiographic Study.
CONCLUSIONS: Cardiac index did not differ between obese pregnant women and those with normal BMI. Their increased left ventricular mass and lower stroke volume index could indicate a limited adaptive reserve. Obese women had minor decreases in septal left ventricular tissue Doppler velocity, but the E/E' average values did not suggest clinically significant diastolic dysfunction. PMID: 29878938 [PubMed - as supplied by publisher]
Source: Anesthesia and Analgesia - June 5, 2018 Category: Anesthesiology Authors: Buddeberg BS, Fernandes NL, Vorster A, Cupido BJ, Lombard CJ, Swanevelder JL, Girard T, Dyer RA Tags: Anesth Analg Source Type: research

Comparison of bioreactance and echocardiographic non-invasive cardiac output monitoring and myocardial function assessment in primagravida women
Conclusions.</strong> Stroke volume and CO measurements obtained using NICOM<sup>®</sup> were comparable to those obtained using echocardiography, with acceptable limits of agreement. Increased maternal BMI negatively impacts LV diastolic function measured using tissue Doppler imaging.</span>
Source: British Journal of Anaesthesia - April 8, 2017 Category: Anesthesiology Source Type: research

Comparison of left-side and right-side approaches for chest compressions in the left-lateral tilt position: a manikin study of maternal cardiopulmonary resuscitation
The 2010 American Heart Association (AHA) Guidelines for Resuscitation emphasize the importance of high-quality chest compressions as a key determinant of successful cardiopulmonary resuscitation (CPR). During pregnancy the uterus can compress the inferior vena cava impeding venous return and thereby reducing stroke volume and cardiac output. Therefore, to maximize the effectiveness of chest compressions in pregnancy, a slight modification has been recommended; the AHA guidelines suggest that the 27–30° left-lateral tilt (LLT) position may improve the effectiveness of chest compressions. Chest compressions may be perfor...
Source: International Journal of Obstetric Anesthesia - September 3, 2013 Category: Anesthesiology Authors: N. Komasawa, R. Ueki, N. Yamamoto, Y. Kaminoh, C. Tashiro Tags: Correspondence Source Type: research

Accuracy and precision of the ultrasound cardiac output monitor (USCOM 1A) in pregnancy: comparison with three-dimensional transthoracic echocardiography
Conclusions USCOM has acceptable agreement with 3D-TTE for the measurement of CO in pregnancy. The positive bias of the USCOM, particularly in the FT mode, may be due to the hyperdynamic cardiovascular state in pregnancy. We suggest using the TP mode in this patient population.
Source: British Journal of Anaesthesia - September 18, 2014 Category: Anesthesiology Authors: McNamara, H., Barclay, P., Sharma, V. Tags: Obstetrics Source Type: research

Hypertensive Disorders and Pregnancy-related Stroke: Frequency, Trends, Risk Factors, and Outcomes
(Obstet Gynecol. 2015;125(1):124–131)
Source: Obstetric Anesthesia Digest - November 20, 2015 Category: Anesthesiology Tags: Epidemiologic Reports, Surveys Source Type: research

Clinical ‘pearls’ of maternal critical care Part 2: sickle-cell disease in pregnancy
Purpose of review: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. Recent findings: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined. The role of the multidisciplinary team cannot be overstated. Massive obstetric hemorrhage in this population is difficult, and unique consideratio...
Source: Current Opinion in Anaesthesiology - May 13, 2017 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jeanette R. Bauchat Source Type: research

Severe Maternal Morbidity in a Large Cohort of Women With Acute Severe Intrapartum Hypertension
(Am J Obstet Gynecol. 2016;215(1):91.e1–91.e7) Adverse effects of hypertensive disorders of pregnancy such as stroke, eclampsia, hemolysis, elevated liver enzymes, low platelet count syndrome, renal failure, and disseminated intravascular coagulation are commonly associated with high rates of maternal morbidity and mortality in the United States. The present study aimed to analyze existing management patterns in a large group of women with severe intrapartum hypertension, to determine the maternal morbidity associated with severe intrapartum hypertension and compare it to that in women without severe hypertension.
Source: Obstetric Anesthesia Digest - May 18, 2017 Category: Anesthesiology Tags: Mechanisms, Equipment, Hazards Source Type: research

Pre-eclampsia and acute pulmonary embolism —the importance of making a differential diagnosis: a case report
We describe the case of a 41-year-old pregnant patient who presented at 38  weeks of gestation for an urgent cesarean section, with new onset of pre-eclampsia as the initial diagnosis. The intraoperative course was complicated by seizures and hemodynamic collapse. Initially, the presentation of seizure pointed to pre-eclampsia/eclampsia; however, with careful consideratio n of each event as it occurred, the correct diagnosis was later determined to be pulmonary embolism and stroke. This case illustrates the importance of considering multiple possible etiologies, even when a particular diagnosis seems obvious.
Source: Journal of Anesthesia - August 5, 2017 Category: Anesthesiology Source Type: research

Clearsight ™ use for haemodynamic monitoring during the third trimester of pregnancy - A validation study.
During pregnancy, haemodynamic changes occur progressively, with impairment to diastolic function, a decrease in total vascular resistance and significant increases in cardiac output (CO) and stroke volume (SV).1,2 Haemodynamic assessment is challenging in pregnant women. In routine practice, clinical signs and BP measurements are insufficient measures of CO. This is due to the changes in vascular resistance, which are physiological characteristics of pregnancy or can be induced secondary to spinal anaesthesia in this population.
Source: International Journal of Obstetric Anesthesia - May 7, 2018 Category: Anesthesiology Authors: G. Duclos, A. Hili, N. Resseguier, C. Kelway, M. Haddam, A. Bourgoin, X. Carcopino, L. Zieleskiewicz, M. Leone Tags: Original Article Source Type: research