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Maternal Outcomes of Placental Abruption With Intrauterine Fetal Death and Delivery Routes: A Nationwide Observational Study 胎盘早破合并宫内胎儿死亡的产妇结局及分娩方式：一项全国性观察研究
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016040.21838.33
Y. Wada, H. Takahashi, Y. Sasabuchi, R. Usui, M. Ogoyama, H. Suzuki, A. Ohkuchi, H. Fujiwara
{"title":"Maternal Outcomes of Placental Abruption With Intrauterine Fetal Death and Delivery Routes: A Nationwide Observational Study","authors":"Y. Wada, H. Takahashi, Y. Sasabuchi, R. Usui, M. Ogoyama, H. Suzuki, A. Ohkuchi, H. Fujiwara","doi":"10.1097/01.aoa.0001016040.21838.33","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016040.21838.33","url":null,"abstract":"(Acta Obstet Gynecol Scand. 2023;102:708–715)\u0000 Both maternal and neonatal morbidity and mortality are associated with placental abruption (PA), a condition where the placenta prematurely separates from the uterine wall before or during labor. PA and intrauterine fetal death (IUFD) can co-occur, making a delivery more complex as well as high risk, as shown through increased maternal morbidity rates. Worldwide, delivery for mothers with PA and IUFD varies between vaginal delivery (VD) and cesarean delivery (CD), although various sources cite VD as the preferred method. Frequent complications of VD for PA with IUFD includes a longer delivery time, uterine rupture, and substantial blood loss. CD is associated with hemorrhagic shock and hematoma formation due to a greater increase in blood loss. Limited, small-scale studies have been performed comparing VD and CD and the effect on maternal morbidity in cases with IUFD and PA; however, this study uses a large data set to understand the relationship between delivery method and morbidity in cases of PA with IUFD.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"59 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102804","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
Gestational Diabetes Mellitus and Labor Analgesia: Nationwide Register‐Based Analysis in Finland 妊娠糖尿病与分娩镇痛：基于芬兰全国登记册的分析
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015968.12988.9f
I. Kuitunen, S. Vähä-Tuisku, T. Huttunen
{"title":"Gestational Diabetes Mellitus and Labor Analgesia: Nationwide Register‐Based Analysis in Finland","authors":"I. Kuitunen, S. Vähä-Tuisku, T. Huttunen","doi":"10.1097/01.aoa.0001015968.12988.9f","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015968.12988.9f","url":null,"abstract":"(Acta Diabetol. 2022;59:1515–1517)\u0000 Diabetes mellitus (DM) has an impact on patient analgesia, necessitating higher postoperative analgesia doses. Gestational DM’s (GDM) influence on labor analgesia must be studied better. The National Institute for Health and Care Excellence lacks recommendations. A lone study found increased opioid use postcesarean delivery (CD) in GDM patients, who are generally more obese. Previous analyses revealed minimal differences in labor analgesia based on obesity grade. With rising GDM incidence, understanding its impact on labor analgesia is crucial. Our national-level study aims to compare labor analgesia between GDM and non-GDM patients, addressing this gap in research.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"9 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101351","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
Obstetric Clinical Trial Diversity 产科临床试验多样性
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015912.47620.ee
J. R. Steinberg, J. DiTosto, B. E. Turner, D.R. Roque, L.M. Yee
{"title":"Obstetric Clinical Trial Diversity","authors":"J. R. Steinberg, J. DiTosto, B. E. Turner, D.R. Roque, L.M. Yee","doi":"10.1097/01.aoa.0001015912.47620.ee","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015912.47620.ee","url":null,"abstract":"(Obstet Gynecol. 2023;142:840–843)\u0000 Clinical trials are typically considered the highest quality evidence that informs clinical practice; however, there are gaps in reporting patient demographics, as well as in the diversity of groups enrolled in clinical trials. Obstetrics in particular has much to lose from underrepresentation, as there are high-impact racial and ethnic disparities in obstetric care that represent life and death situations for many individuals. This article is a research letter focusing on systemic racism and its impact on Asian American health in obstetrics and gynecology.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"73 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101862","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
Tranexamic Acid, as an Adjunct to Oxytocin Prophylaxis, in the Prevention of Postpartum Hemorrhage in Women Undergoing Elective Cesarean Section: A Single-Center Double-Blind Randomized Controlled Trial 氨甲环酸作为催产素预防的辅助药物，用于预防择期剖宫产妇女产后出血：单中心双盲随机对照试验
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016020.37304.ff
S.H. Lee, M.E. Kwek, S. Tagore, A. Wright, C.W. Ku, A. Teong, A. Tan, S.W.C. Lim, D. Yen, C. Ang, R. Sultana, C.H.F. Lim, D. Mathur, M. Mathur
{"title":"Tranexamic Acid, as an Adjunct to Oxytocin Prophylaxis, in the Prevention of Postpartum Hemorrhage in Women Undergoing Elective Cesarean Section: A Single-Center Double-Blind Randomized Controlled Trial","authors":"S.H. Lee, M.E. Kwek, S. Tagore, A. Wright, C.W. Ku, A. Teong, A. Tan, S.W.C. Lim, D. Yen, C. Ang, R. Sultana, C.H.F. Lim, D. Mathur, M. Mathur","doi":"10.1097/01.aoa.0001016020.37304.ff","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016020.37304.ff","url":null,"abstract":"(BJOG. 2023;130(9):1007–1015)\u0000 Postpartum hemorrhage (PPH) is the main cause of maternal morbidity and mortality worldwide. The World Health Organization (WHO) recommends administration of uterotonics including oxytocin to prevent PPH, but uterotonics alone may not fully prevent PPH from other causes. The World Maternal Antifibrinolytic Trial (WOMAN Trial) reported that tranexamic acid (TXA) reduced PPH-related mortality in PPH cases, and as a result the WHO has included the administration of TXA into their recommendations for PPH treatment. There is speculation about the potential role of prophylactic TXA in preventing PPH.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100682","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
Clinical Triggers and Vital Signs Influencing Crisis Acknowledgment and Calls for Help by Anesthesiologists: A Simulation-Based Observational Study 影响麻醉医师识别危机和呼救的临床触发因素和生命体征：基于模拟的观察研究
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016008.59181.d9
L.H. Matern, R. Gardner, J.W. Rudolph, R. Nadelberg, C. Buléon, R.D. Minehart
{"title":"Clinical Triggers and Vital Signs Influencing Crisis Acknowledgment and Calls for Help by Anesthesiologists: A Simulation-Based Observational Study","authors":"L.H. Matern, R. Gardner, J.W. Rudolph, R. Nadelberg, C. Buléon, R.D. Minehart","doi":"10.1097/01.aoa.0001016008.59181.d9","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016008.59181.d9","url":null,"abstract":"(J Clin Anesth. 2023;90:111235 |https://doi.org/10.1016/j.jclinane.2023.111235)\u0000 Swiftly mobilizing resources in perioperative emergencies is crucial for patient survival, with anesthesiologists typically bearing this responsibility. Recognizing the urgency, the call for help is emphasized through formalized “stat” calls. However, the timing of seeking assistance remains subjective, posing a challenge. While empirical evidence highlights blood pressure thresholds indicative of harm, ambiguity surrounds terms like “early” in crisis management. An assumption that anesthesiologists must possess all answers hinders timely collaboration, impacting patient care. Factors affecting crisis acknowledgment, especially in simulated settings, were explored among MOCA course participants. Acknowledgment, a pivotal step in emergency response, was scrutinized alongside potential differences between active participants and observers. This investigation seeks to expose vulnerabilities in ACRM implementation, guiding future studies on crisis management in perioperative settings.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"92 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101156","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
State Public Insurance Coverage Policies and Postpartum Care Among Immigrants 州公共保险覆盖政策与移民产后护理
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015952.14846.cc
M.W. Steenland, R.E. Fabi, M. Bellerose, A. Desir, M. S. White, L.R. Wherry
{"title":"State Public Insurance Coverage Policies and Postpartum Care Among Immigrants","authors":"M.W. Steenland, R.E. Fabi, M. Bellerose, A. Desir, M. S. White, L.R. Wherry","doi":"10.1097/01.aoa.0001015952.14846.cc","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015952.14846.cc","url":null,"abstract":"(JAMA. 2023;330(3):238–246)\u0000 While physicians and professional medical organizations advocate for routine postpartum care for adults, some states impose restrictions on public insurance coverage for undocumented immigrants and immigrants granted legal documentation status within the past 5 years. The aim of this study was to investigate the relationship between public insurance coverage and postpartum care among low-income immigrants and to determine the difference in postpartum care receipt between immigrants and nonimmigrants.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"72 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101871","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
Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force 妊娠期高血压疾病筛查：为美国预防服务工作组提供的最新证据报告和系统回顾
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015920.48053.30
J. T. Henderson, E. M. Webber, R. G. Thomas, K. K. Vesco
{"title":"Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force","authors":"J. T. Henderson, E. M. Webber, R. G. Thomas, K. K. Vesco","doi":"10.1097/01.aoa.0001015920.48053.30","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015920.48053.30","url":null,"abstract":"(JAMA. 2023;330:11:1083–1091)\u0000 The incidence of hypertensive disorders, including pre-eclampsia, during pregnancy has been increasing since the early 1990s, putting more pregnant women and neonates at risk of death or illness. The Black population is affected disproportionately, with the risk of dying of pre-eclampsia 5 times higher for Blacks than for Whites. In 2017, the US Preventive Services Task Force recommended screening pregnant women for pre-eclampsia by taking blood pressure (BP) readings throughout pregnancy at office visits. This systematic review examined different screening protocols to evaluate if some were more effective than others.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"20 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100339","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
Management and Outcomes of Pulmonary Artery Hypertension and Eisenmenger Syndrome During Pregnancy: A Prospective Observational Cohort Study 妊娠期肺动脉高压和艾森曼格综合征的管理和结果：前瞻性观察队列研究
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016068.86521.61
N. Jha, M. B. Divya, A.K. Jha
{"title":"Management and Outcomes of Pulmonary Artery Hypertension and Eisenmenger Syndrome During Pregnancy: A Prospective Observational Cohort Study","authors":"N. Jha, M. B. Divya, A.K. Jha","doi":"10.1097/01.aoa.0001016068.86521.61","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016068.86521.61","url":null,"abstract":"(BJOG. 2023;130(10):1258–1268)\u0000 Pregnancies complicated by pulmonary arterial hypertension (PAH) and Eisenmenger syndrome often result in severe maternal and fetal morbidity and mortality. Clinicians often counsel women with these conditions to avoid pregnancy or terminate a pregnancy. Multidisciplinary specialty centers, however, have seen good outcomes in these high-risk women and their babies.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"3 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100386","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
The Need for Maternal Critical Care Education, Point-of-Care Ultrasound and Critical Care Echocardiography in Obstetric Anesthesiologists Training 产科麻醉师培训中孕产妇重症监护教育、护理点超声和重症监护超声心动图的必要性
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015904.76475.e9
C. Padilla, C. Ortner, A. Dennis, L. Zieleskiewicz
{"title":"The Need for Maternal Critical Care Education, Point-of-Care Ultrasound and Critical Care Echocardiography in Obstetric Anesthesiologists Training","authors":"C. Padilla, C. Ortner, A. Dennis, L. Zieleskiewicz","doi":"10.1097/01.aoa.0001015904.76475.e9","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015904.76475.e9","url":null,"abstract":"(Int J Obstet Anesth 2023;55:103880/https://doi.org/10.1016/j.ijoa.2023.103880/0208-5216/)\u0000 The rise in complex obstetric cases is a global phenomenon. In high-income countries, medical issues, particularly cardiovascular conditions, contribute to maternal morbidity and mortality, challenging traditional educational and clinical approaches. Obstetric critical care principles warrant standardized education, including ultrasound applications like POCUS for real-time assessment of cardiac, pulmonary, airway, and gastric parameters. Despite the increasing need for maternal critical care, formal certification programs are lacking globally. The United States and the UK lack specific educational standards for maternal critical care in anesthesiology.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"83 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101842","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
Prenatal Intravenous Magnesium at 30 to 34 Weeks’ Gestation and Neurodevelopmental Outcomes in Offspring: The MAGENTA Randomized Clinical Trial 妊娠 30 至 34 周时的产前静脉注射镁与后代的神经发育结果：MAGENTA 随机临床试验
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016052.26395.51
C. Crowther, P. Ashwood, P. F. Middleton, A. McPhee, T. Tran, J.E. Harding
{"title":"Prenatal Intravenous Magnesium at 30 to 34 Weeks’ Gestation and Neurodevelopmental Outcomes in Offspring: The MAGENTA Randomized Clinical Trial","authors":"C. Crowther, P. Ashwood, P. F. Middleton, A. McPhee, T. Tran, J.E. Harding","doi":"10.1097/01.aoa.0001016052.26395.51","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016052.26395.51","url":null,"abstract":"(JAMA. 2023;330(7):603–614)\u0000 Preterm infants have a greater risk of cerebral palsy, a common motor disability for which there is no cure. As such, primary prevention is especially important. The use of magnesium sulfate while pregnant has been shown in randomized clinical trials to be helpful for those at risk of early preterm delivery by improving an infant’s chance of survival without cerebral palsy. As a result, magnesium sulfate is recommended for fetal neuroprotection. However, there is a lack of data surrounding the ideal gestational age for using it prenatally.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"16 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102521","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
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