Journal of Obstetric Anaesthesia and Critical Care最新文献_第9页

Pathophysiologic and anaesthetic considerations in iron deficiency anaemia and pregnancy; An update 缺铁性贫血和妊娠的病理生理和麻醉考虑一个更新

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_46_21

Sunanda Gupta, Karuna Sharma, Charu Sharma, A. Chhabra, Lalita Jeengar, Nitasha Sharma

{"title":"Pathophysiologic and anaesthetic considerations in iron deficiency anaemia and pregnancy; An update","authors":"Sunanda Gupta, Karuna Sharma, Charu Sharma, A. Chhabra, Lalita Jeengar, Nitasha Sharma","doi":"10.4103/joacc.joacc_46_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_46_21","url":null,"abstract":"Anaemia is common during pregnancy, especially in low- and middle-income countries, and iron deficiency is the most common cause of anaemia worldwide. Symptoms relating to iron deficiency can be diverse, which relate to the depletion of cellular Fe function in different tissue organs and may exist long before Fe deficiency restricts erythropoiesis and anaemia develops. It is important to understand the pathophysiological and adaptation changes occurring during anaemia as long-standing changes affect the various organ systems and may impact both maternal and neonatal outcomes. There is growing evidence linking maternal IDA with subsequent neonatal cognitive and neurobehavioral outcomes, which makes it imperative that IDA should be treated early in pregnancy. Preoperative optimization with iron therapy (oral or parenteral) and erythropoiesis-stimulating agents vs replenishing O2-carrying capacity by transfusion must always be balanced against transfusion-associated risks. The anaesthetic management in parturients with severe anaemia depends on a multitude of factors, such as severity of iron deficiency anaemia, co-morbid diseases, extent of physiological compensation, and type and nature of anticipated haemorrhagic loss. This review summarizes the pathophysiological changes and adaptations consequent to oxygen delivery and iron homeostasis, therapeutic management, and anaesthetic challenges in pregnancy with IDA. It is based on electronic search strategies from Ovid Medline, Ovid Embase and PubMed (up to June 2021) along with relevant college and society web-based resources, including Royal College of Obstetricians and Anaesthesiologists, National Institute for Health and Clinical Excellence College and Society (NICE), Patient Blood Management Guidelines and American College of Obstetricians and Gynaecologists (ACOG) practice bulletins.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44166353","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

Extension of labor epidural analgesia for emergency cesarean section: A survey of practice in the United Kingdom 分娩硬膜外镇痛在紧急剖宫产中的应用：英国的实践调查

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_36_21

Thomas E Potter, N. Desai

引用次数: 0

Sickle cell disease in pregnancy and anaesthetic implications: A narrative review 镰状细胞病在妊娠和麻醉的影响:叙述回顾

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_76_21

Yudhyavir Singh, Alka Chabra, V. Venkateswaran, A. Trikha

{"title":"Sickle cell disease in pregnancy and anaesthetic implications: A narrative review","authors":"Yudhyavir Singh, Alka Chabra, V. Venkateswaran, A. Trikha","doi":"10.4103/joacc.joacc_76_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_76_21","url":null,"abstract":"Sickle cell disorder (SCD) is a genetic disorder of haemoglobin with a wide spectrum of severity and manifestations. It is a significant global public health problem and is mainly widespread among many tribal populations. Sickle cell disease (SCD) in pregnancy poses a unique challenge due to the physiological changes in pregnancy, the multitude of various organs involved, and its complications. The databases of PubMed, MedLine ResearchGate, EMbase, Scopus and Google Scholar were searched for literature about SCDs published up to 2021. Search terms and phrases used were 'sickle cell disease', 'sickle cell disease and pregnancy', 'anaesthesia and analgesia in sickle cell disease' and 'transfusion in sickle cell disease'. Original articles, guidelines, review articles, case reports, letters to editor and abstracts were reviewed with particular focus on pathophysiology and anaesthetic implications of sickle cell anaemia with pregnancy. While ample literature is available on SCDs, there is a paucity of literature on SCDs with pregnancy. In this review, we have attempted to present the relevant literature in a comprehensible manner.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43984888","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

Case series of perimortem caesarean delivery during maternal cardiac arrest: Our initial experience and audit 产妇心脏骤停期间剖宫产病例系列：我们的初步经验和审计

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_35_21

M. Kaur, R. Jain, Aayush Gulati, Ashima Taneja, Sahil Sardana, A. Grewal

{"title":"Case series of perimortem caesarean delivery during maternal cardiac arrest: Our initial experience and audit","authors":"M. Kaur, R. Jain, Aayush Gulati, Ashima Taneja, Sahil Sardana, A. Grewal","doi":"10.4103/joacc.joacc_35_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_35_21","url":null,"abstract":"Cardiac arrest in pregnancy is a rare, catastrophic condition that can lead to major morbidity and mortality for both mother and baby. Prompt high-quality resuscitative measures need to be employed keeping in mind the altered maternal anatomy and physiology, presence of a compromised fetus, and an urgent need to deliver the baby for optimizing maternal and fetal outcomes. Therefore, it is important that health care facilities make appropriate systems in consonance with the latest recommendations of cardiopulmonary resuscitation (CPR) for this special group of parturients. Despite protocols and training, the clinical scenario often is emotionally overwhelming and brings forth an enormous cognitive load of resuscitating two lives along with the performance of perimortem cesarean delivery (PMCD) or resuscitative hysterotomy. We report five cases of maternal cardiac arrest referred to our tertiary care hospital, wherein PMCD was performed as part of ongoing high-quality CPR with manual left uterine displacement. Two mothers had a return of spontaneous circulation (ROSC), whereas ROSC could not be achieved in three. One neonate had an Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score of 8. Four neonates needed CPR, and ROSC was achieved in two of these. Underlying causes were mainly severe hemorrhagic shock, eclampsia, severe pre-eclampsia, and anaphylactic reactions. Poor survival rates in our initial experience of setting up a maternal code blue mechanism as per the guidelines reflect the need for reinforcement of early PMCD, use of cognitive aids, and retraining using mock drills and simulation for better outcomes in the future. In addition, awareness of modified obstetric warning signs in peripheral hospitals is essential so that timely referral to tertiary care centers can help salvage precious lives.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41954668","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

Relapsing polychondritis in a primiparous women for elective lower segment caesarean section 初产妇选择性下段剖腹产的复发性多软骨炎

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_24_21

Chin-ho. Chan, Anqi Lu, M. Mok

引用次数: 0

Accidental Dural Puncture With An Introducer Needle (18 G) For Elective Caesarean Section: A case report 选择性剖宫产硬膜穿刺针（18G）意外穿刺1例报告

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_59_21

Omar Rajab, S. Kanawati, M. Barada, Z. Naja, L. Sinno

引用次数: 0

Effect of implementation of perineal tear pain management programme on pain scores 实施会阴撕裂疼痛管理方案对疼痛评分的影响

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_45_21

K. Ramaswamy, N. Hooker, Z. Kotyra, Saravanan Solai Dhanashekaran, S. Soltanifar, N. Aldamluji

{"title":"Effect of implementation of perineal tear pain management programme on pain scores","authors":"K. Ramaswamy, N. Hooker, Z. Kotyra, Saravanan Solai Dhanashekaran, S. Soltanifar, N. Aldamluji","doi":"10.4103/joacc.joacc_45_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_45_21","url":null,"abstract":"Background: Perineal tear (PT) occurs in more than 85% of the women undergoing vaginal birth and up to 11% of these can be third- and fourth-degree tears and the majority suffer from pain. Poorly managed pain can impact the mother and her capacity to look after the baby. The institution introduced a PT pain management programme (PPP) as part of a quality improvement programme. This paper is a retrospective analysis to determine the effect of this implementation on the pain scores and patient satisfaction. Objective: Does the PT pain management programme improve pain scores at rest 12 and 24 h post-repair? Does the programme improve maternal satisfaction? Methods: A pain management protocol had been implemented for women with PT from January 1, 2020. To assess the effectiveness of the protocol, data were retrieved from electronic medical records (Cerner Millennium) of 100 women who had a PT from January 1, 2019, to March 31, 2019 (pre-PPP), and 96 women who had a PT from April 1, 2020, to July 31, 2020 (post-PPP). We included consecutive women who had second-, third- and fourth-degree tears. Results: A significant difference in the pain scores at 12 h (mean ± SD [difference of means], 95% CI) (2.17 ± 1.11 vs. 4.5 ± 1.65 [2.33], 1.93–2.73, t (194) = 11.54, P","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43932000","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

Caesarean section in a case of acute coronary syndrome - A case report 剖宫产术治疗急性冠状动脉综合征1例

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_94_20

N. Mehta, K. Shah, Y. Bhatt

引用次数: 0

Management of kyphoscoliotic pregnant patient presenting with impending respiratory failure – A case report 后凸畸形妊娠患者并发呼吸衰竭的处理——一例报告

Journal of Obstetric Anaesthesia and Critical Care Pub Date : 2021-07-01 DOI: 10.4103/joacc.joacc_92_20

Shashikiran, R. Bala

引用次数: 0

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":" ","pages":""},"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