Journal of Obstetric Anaesthesia and Critical Care最新文献_第10页

Sequential organ failure assessment score for predicting outcome of severely ill obstetric patients admitted to intensive care unit 序贯器官衰竭评估评分预测重症监护病房产科重症患者的预后

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_15_21

U. Srivastava, Yogita Dwivedi, S. Verma, A. Kannaujia, S. Ambasta, Israel Lalramthara

{"title":"Sequential organ failure assessment score for predicting outcome of severely ill obstetric patients admitted to intensive care unit","authors":"U. Srivastava, Yogita Dwivedi, S. Verma, A. Kannaujia, S. Ambasta, Israel Lalramthara","doi":"10.4103/joacc.joacc_15_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_15_21","url":null,"abstract":"Background and Aim: Severe maternal illness is a life-threatening condition for pregnant women and often requires admission into the ICU. The aim was to evaluate the performance of maximum sequential organ failure assessment (SOFA) score to predict the outcome of patients admitted to ICU. Material and Methods: This prospective study was done on 121 consecutive women with severe obstetric illness admitted to the ICU during one year. Basic demographic, obstetrical data, indication of admission to ICU and interventions done were noted. SOFA score was evaluated according to the worst score for each of its six components every 24 hr till discharge or death in ICU. The receiver-operator characteristic (ROC) curve was constructed to predict the outcome of ICU. For analysis, patients were categorized as survivors and non-survivors. Results: Out of 121 patients admitted, 65 survived and 56 died with mortality rate of 45.9%. There were no differences among survivor and non-survivor patients regarding demographic data, obstetrical data and interventions done, but anaemia and inadequate ante natal care was more common in non survivors. ICU utilisation rate of obstetric patients was 1.9%. Most patients were admitted due to obstetric causes (87.6%), mainly for hypertensive disorders (46%) and were post caesarean (84.29%). Total maximum SOFA scores were higher in non-survivors than in survivors (14.09 ± 5.53 vs 7.47 ± 4.58, P","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41787426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pseudodextrocardia delaying the diagnosis of peripartum cardiomyopathy 假右心延迟诊断围产期心肌病

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_27_21

A. Bandyopadhyay, N. Sahni, G. Kanth

引用次数: 0

Airway changes before & after delivery-does labour has any effect on the modified mallampati score? 分娩前后的气道变化对改良的mallampati评分有影响吗？

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_89_20

A. Das, N. Sabharwal, M. Kumar

{"title":"Airway changes before & after delivery-does labour has any effect on the modified mallampati score?","authors":"A. Das, N. Sabharwal, M. Kumar","doi":"10.4103/joacc.joacc_89_20","DOIUrl":"https://doi.org/10.4103/joacc.joacc_89_20","url":null,"abstract":"Background: Changes in modified mallampati grade occur with the progress of pregnancy, labor, and delivery due to various reasons. This could lead to unanticipated difficulties in airway management, especially if the parturient were to undergo a surgical procedure in the postpartum period. Our study aimed to evaluate the change in airway parameters after delivery in parturient undergoing lower segment cesarean section (LSCS) under spinal anesthesia. Materials and Methods: This study was conducted at Vardhaman Mahavir (VMMC) and Safdarjung Hospital over a period of 18 months. A total of 160 patients posted for either elective or emergency cesarean section under spinal anesthesia were enrolled in the study (80 in each group). Airway parameters including modified mallampati grade (MMPG) were measured at various time intervals – before cesarean section (T1) and 2 h (T2), 6 h (T3), 24 h (T4), 48 h (T5), and 72 h (T6) after delivery and analyzed statistically. Results: Changes in MMPG occurred in 71.25% of cases in the emergency group as compared with 40% of cases in the elective group (P = 0.0001). The mean MMPG was significantly higher from 2 h up to 72 h after LSCS in the emergency group (having more patients in active labor). (P = 0.0001). Maximum changes in MMPG occurred 6 h after delivery in both groups. Normalization of MMPG to its precesarean value occurred earlier in elective patients (P = 0.0005). An association was found between the duration of labor and normalization of changes in MMPG to its preoperative value (P = 0.023). Conclusion: Airway changes in pregnant women are seen to worsen after emergency LSCS under spinal anesthesia and are affected by prolonged labor. Therefore, the maternal airway should be reassessed after the delivery of the baby, for any surgical procedure thereafter.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46414512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Pregnancy in thalassemia, anesthetic implication and perioperative management- A narrative review 地中海贫血的妊娠、麻醉意义和围手术期管理——叙述性综述

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_77_21

Abhishek Singh, Karuna Sharma, V. Venkateswaran, A. Trikha

{"title":"Pregnancy in thalassemia, anesthetic implication and perioperative management- A narrative review","authors":"Abhishek Singh, Karuna Sharma, V. Venkateswaran, A. Trikha","doi":"10.4103/joacc.joacc_77_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_77_21","url":null,"abstract":"Advancement in the treatment of thalassemia has increased the life span of female patients, with the result that they are reaching the reproductive age group and expecting childbirth. Anesthesia is challenging in such patients due to ineffective erythropoiesis and multiple system involvement as a result of iron overload and chelation therapy. Careful management of the preconception phase, various conception strategies, and multidisciplinary management of pregnancy and childbirth can lead to a healthy and successful outcome of pregnancy. This review provides an overview of the pathophysiology and clinical manifestation of alpha and beta-thalassemia in pregnancy and its successful management. All available literature related to thalassemia was searched in major databases like PubMed, Embase, Scopus, and Google Scholar. Original articles, review articles, book chapters, guidelines, case reports, and correspondence were reviewed for pathophysiology, clinical manifestations, and anesthetic management of thalassemia during pregnancy with keywords like thalassemia, Cooley's anemia, thalassemia and pregnancy, anesthetic management of thalassemia, labor analgesia in thalassemia, and transfusion in thalassemia.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41660033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implications of active infective endocarditis with pregnancy and its management 活动性感染性心内膜炎与妊娠的关系及其处理

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_10_21

P. Bhatia, D. Dwivedi, A. Gautam, Shalendra Singh

引用次数: 1

A ten-year-old obstetric anaesthesia journal: Musings of an editor 一本有十年历史的产科麻醉杂志:一位编辑的沉思

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_86_21

A. Trikha

引用次数: 0

“Too powerful to push”: A rise in “on demand” caesarean section “太强大了，无法推动”：“按需”剖腹产的增加

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_42_21

Ketan Parikh, S. Pandya

引用次数: 0

Acute fatty liver of pregnancy leading to a delayed hepatic failure necessitating liver transplantation: A case report 妊娠期急性脂肪肝致迟发性肝衰竭需要肝移植一例报告

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_16_21

Patriot Yang, R. Sikachi, M. Gerasimov, J. Aronsohn, G. Palleschi

{"title":"Acute fatty liver of pregnancy leading to a delayed hepatic failure necessitating liver transplantation: A case report","authors":"Patriot Yang, R. Sikachi, M. Gerasimov, J. Aronsohn, G. Palleschi","doi":"10.4103/joacc.joacc_16_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_16_21","url":null,"abstract":"Acute fatty liver of pregnancy (AFLP) is a potentially fatal metabolic disorder in pregnant patients that requires urgent delivery and aggressive medical and aesthetic management of maternal complications associated with acute liver failure. A 41-year-old female (79 kg) G1P0 at 31 weeks gestation presented with nausea, vomiting, pruritus, and jaundice. A diagnosis of severe liver dysfunction secondary to AFLP was made. We proceeded with urgent delivery under general anaesthesia. The patient had an uncomplicated caesarean section and gave birth to female infant with Apgar scores of 7 and 8. The patient remained stable for the following 2 weeks, however, given the lack of further recovery of hepatic function, a transjugular liver biopsy was performed, revealing persistent AFLP. She received N-acetylcysteine infusion and 4 cycles of plasma exchange with no improvement. Over the next few days her mental status worsened and her liver functions further deteriorated. She was listed for a deceased liver donor transplant and underwent successful orthotopic liver transplantation. She was discharged on post-operative day (POD) 14 of liver transplant.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42367976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Failure of resuscitative hysterotomy to rescue peripartum cardiac arrest 恢复性剖宫术抢救围产期心脏骤停的失败

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_30_21

Isha Kunagpa, B. Sharma, P. Verma, S. Siwatch, G. Prasad, Kajal Sharma

引用次数: 1

Taurine as an adjunct therapy for early left ventricular recovery in peripartum cardiomyopathy 牛磺酸辅助治疗围产期心肌病早期左心室恢复

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-01-01 DOI: 10.4103/joacc.JOACC_36_20

H. Zaki, M. Sweed, Rania M. Ali, M. Abdelhafeez

{"title":"Taurine as an adjunct therapy for early left ventricular recovery in peripartum cardiomyopathy","authors":"H. Zaki, M. Sweed, Rania M. Ali, M. Abdelhafeez","doi":"10.4103/joacc.JOACC_36_20","DOIUrl":"https://doi.org/10.4103/joacc.JOACC_36_20","url":null,"abstract":"Background and Aims: The pathophysiology of peripartum cardiomyopathy is not fully understood. Despite standard medical therapy, both morbidity and mortality remain high. Restoration of inflammatory cytokine balance may hold promise for therapy. Taurine has a powerful immune-modulatory and anti-inflammatory in addition to positive inotropic effect. This study evaluates the effect of taurine infusion on clinical status, left ventricular function, circulating plasma levels of N-terminal brain natriuretic peptide and C-reactive protein in women with peripartum cardiomyopathy. Methods: Forty women with peripartum cardiomyopathy admitted postpartum to the ICU were randomly assigned to one of two groups (20 in each group): Group T received taurine infusion and Group C received normal saline infusion over 24 hours for 5 days. Both groups received standard heart failure therapy according the institutional treatment protocol. Results: In the taurine group on day 5, there was a significant reduction in LVEDD and LVESD and significant increase in LVEF. All patients had an improvement in LVEF of at least 10% and 5 patients had recovery of LVEF to ≥50% on day 5 while the other 15 patients had LVEF 45- 50%. In the control group on day 5, there was non-significant change in LVEDD, LVESD and LVEF and no patient had recovery of LVEF to ≥50% or showed improvement in LVEF more than 10%. NYHA functional class showed significant increase on day 5 in the taurine group compared to the control group. Seventeen patients (85%) in the taurine group showed improvement of the NYHA functional class at day 5. In contrast, only 2 patients (10%) in the control group showed improvement of NYHA functional class at day 5. Conclusion: Early addition of taurine infusion to standard heart failure therapy improves both; echocardiographic parameters and laboratory parameters but without clinically significant changes in women with peripartum cardiomyopathy.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43318150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1