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Planned Delivery or Expectant Management for Late Preterm Pre-Eclampsia in Low-Income and Middle-Income Countries (CRADLE-4): A Multicenter, Open-Label, Randomized Controlled Trial 中低收入国家早产子痫前期的计划分娩或预产期管理（CRADLE-4）：一项多中心、开放标签、随机对照试验
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016044.78093.29
A. Beardmore-Gray, N. Vousden, P.T. Seed, B. Vwalika, S. Chinkoyo, V. Sichone, A.B. Kawimbe, U. Charantimath, G. Katageri, M.B. Bellad, L. Lokare, K. Donimath, S. Bidri, S. Goudar, J. Sandall, L.C. Chappell, A.H. Shennan
{"title":"Planned Delivery or Expectant Management for Late Preterm Pre-Eclampsia in Low-Income and Middle-Income Countries (CRADLE-4): A Multicenter, Open-Label, Randomized Controlled Trial","authors":"A. Beardmore-Gray, N. Vousden, P.T. Seed, B. Vwalika, S. Chinkoyo, V. Sichone, A.B. Kawimbe, U. Charantimath, G. Katageri, M.B. Bellad, L. Lokare, K. Donimath, S. Bidri, S. Goudar, J. Sandall, L.C. Chappell, A.H. Shennan","doi":"10.1097/01.aoa.0001016044.78093.29","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016044.78093.29","url":null,"abstract":"(Lancet. 2023;402:386–396)\u0000 Pre-eclampsia is a relatively common condition and poses a disproportionately high risk to women in low-income and middle-income countries where it is a leading cause of maternal morbidity and mortality, estimated to have caused more than 42,000 deaths. The only known treatment is delivery, but there are also risks associated with preterm delivery that can contribute to both maternal and neonatal outcomes. Evidence suggests delivery at 37 weeks optimizes outcomes for both mother and infant, but there is little evidence about delivery in the late preterm gestational period leading up to that, between 34 and 36 and 6/7 weeks. Research in higher income settings has shown that fetal death in these cases is rare, but there are factors in such settings that are unavailable or unrealistic in low-income and middle-income settings. This study aimed to address the gap in knowledge by assessing outcomes related to planned delivery between 34 and 37 weeks in women with pre-eclampsia compared with expectant management during the same gestational period in India and Zambia.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099498","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
Direct Current Cardioversion in Pregnancy: A Multicenter Study 妊娠期直流电心脏起博器：一项多中心研究
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016064.75927.1c
M. Cauldwell, D. Adamson, K. Bhatia, C. Bhagra, A. Bolger, T. Everett, C. Fox, J. Girling, C. Head, K. English, L. Hudsmith, R. James, M. Johnson, L. MacKiliop, F.M. McAuliffe, G. Mariappa, E. Orchard, M. O'Brien, F. Siddiqui, L. Simpson, M. Simpson, P. Timmons, S. Vause, G. Wander, N. Walker, P. Steer
{"title":"Direct Current Cardioversion in Pregnancy: A Multicenter Study","authors":"M. Cauldwell, D. Adamson, K. Bhatia, C. Bhagra, A. Bolger, T. Everett, C. Fox, J. Girling, C. Head, K. English, L. Hudsmith, R. James, M. Johnson, L. MacKiliop, F.M. McAuliffe, G. Mariappa, E. Orchard, M. O'Brien, F. Siddiqui, L. Simpson, M. Simpson, P. Timmons, S. Vause, G. Wander, N. Walker, P. Steer","doi":"10.1097/01.aoa.0001016064.75927.1c","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016064.75927.1c","url":null,"abstract":"(BJOG. 2023;130(10):1269–1274)\u0000 The physiological changes that occur in pregnancy have been associated with new onset and recurrent cardiac arrhythmias. It is common for pregnant patients to experience palpitations in pregnancy, and most of these do not require treatment. However, some arrhythmias require treatment including medications and/or direct current cardioversion (DCCV) to restore the patient’s rhythm. In a recent inquiry into maternal deaths in the United Kingdom (UK), DCCV was not applied consistently and may have resulted in maternal deaths. This study aimed to understand practice surrounding DCCV in the UK, assessing which arrhythmias occurred and how they were treated. In addition, they evaluated outcomes associated with obstetric and neonatal health, including the use of fetal monitoring and whether there were cases where DCCV caused harm to the fetus.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"9 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099787","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
Storage of Emergency Airway Equipment on Labor and Delivery Units 产房紧急气道设备的储存
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015976.49431.15
E.T. Riley, B. Carvalho, G. Abir
{"title":"Storage of Emergency Airway Equipment on Labor and Delivery Units","authors":"E.T. Riley, B. Carvalho, G. Abir","doi":"10.1097/01.aoa.0001015976.49431.15","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015976.49431.15","url":null,"abstract":"(J Clin Anesth. 2022;80:110886 | https://doi.org/10.1016/j.jclinane.2022.110886)\u0000 The imperative need for an operational and prepared environment in labor and delivery (L&D) units, particularly for emergency cesarean delivery (CD), underscores the requirement for a readily available operating room. This preparedness extends to having emergency airway equipment in a state of readiness for immediate use. In an academic tertiary referral institution, which handles ~4600 deliveries annually (with 70% classified as high-risk patients), emergency airway equipment was initially stored preprepared beneath a towel on the front shelf of each anesthesia machine.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099920","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
Maternal Morbidity and Mortality Among Patients With Cancer at Time of Delivery 分娩时癌症患者的孕产妇发病率和死亡率
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016072.85980.10
A.C. Sundermann, J. M. Cate, A.K. Campbell, S.K. Dotters-Katz, E.R. Myers, J.J. Federspiel
{"title":"Maternal Morbidity and Mortality Among Patients With Cancer at Time of Delivery","authors":"A.C. Sundermann, J. M. Cate, A.K. Campbell, S.K. Dotters-Katz, E.R. Myers, J.J. Federspiel","doi":"10.1097/01.aoa.0001016072.85980.10","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016072.85980.10","url":null,"abstract":"(Am J Obstet Gynecol. 2023;229:324.e1–324.e7)\u0000 Women with a cancer diagnosis during pregnancy face higher maternal morbidity and mortality. Current prenatal care guidelines focus on care coordination between obstetricians and oncologists. But knowing more about the risks these women face during delivery could help clinicians provide better care and improve outcomes.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"30 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102478","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
Perinatal Outcomes and the Role of Obstetric Anesthesia Interventions 围产期结果和产科麻醉干预的作用
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015908.87799.94
D.N. Lucas, J. Bamber, S. Quasim
{"title":"Perinatal Outcomes and the Role of Obstetric Anesthesia Interventions","authors":"D.N. Lucas, J. Bamber, S. Quasim","doi":"10.1097/01.aoa.0001015908.87799.94","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015908.87799.94","url":null,"abstract":"(Lancet 2023;401:2038–2039)\u0000 This editorial discusses multiple recent studies that investigated perinatal outcomes and the impact of anesthetic interventions. A prior study published in the Lancet in 2022 reported poorer perinatal outcomes for neonates born to Black women compared to those born to White women. Another study examined nearly 450,000 deliveries and found an association between neonatal outcomes (Apgar <7 at 5 min, need for neonatal resuscitation, and neonatal admission to the intensive care unit) and maternal use of epidural analgesia. The authors of this editorial examined their own data regarding the incidence of obstetric anesthetic procedures among different ethnic groups and found that compared to White British women who had vaginal birth, incidence of epidural analgesia among Bangladeshi, Pakistani, Black African, and Black Caribbean women was much lower. They noted that similar disparities can be found in the United States and reiterated the socioeconomic and systemic disparities as one likely cause for poor neonatal outcomes, suggesting that offering equal access to neuraxial analgesia across all populations could lead to improved neonatal outcomes for Black women.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"2 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098749","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 Anesthesia Manpower and Service Provision Issues: Introduction and European Perspective 产科麻醉人力和服务提供问题：简介和欧洲视角
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016104.61333.2d
E. Guasch, A. Ioscovich, N. Brogly, S. Orbach-Zinger, P. Kranke, E. Morau, F. Gilsanz
{"title":"Obstetric Anesthesia Manpower and Service Provision Issues: Introduction and European Perspective","authors":"E. Guasch, A. Ioscovich, N. Brogly, S. Orbach-Zinger, P. Kranke, E. Morau, F. Gilsanz","doi":"10.1097/01.aoa.0001016104.61333.2d","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016104.61333.2d","url":null,"abstract":"(Int J Obstet Anesth. 2023;55:103647)\u0000 The global perspective on obstetric anesthesia emphasizes the critical role of universal health coverage, particularly during the COVID-19 pandemic. The United Nations prioritizes achieving 80% global universal health coverage by 2030, recognizing the substantial gaps in emergency and essential surgical and anesthesia care. The shortage of health care workers, especially in low-income and middle-income countries (LMIC), is evident, focusing on the lack of anesthesia physicians. In Europe, standards for physician anesthesia providers are currently achieved, but concerns persist about workforce challenges. Obstetric anesthesia practices vary globally, and efforts to address shortages include fellowship programs to enhance competency and efficiency. Examples from European countries, such as Israel, demonstrate diverse approaches to training obstetric anesthesiologists, aiming to ensure quality care amid workforce challenges. The Israel Obstetric Anesthesia Society actively contributes to education and training, highlighting the ongoing need for improvement in aligning standards with daily practice.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102392","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
Economic Cost of Secondary Postpartum Hemorrhage: A Case-Control Study at a Tertiary Hospital in Australia 继发性产后出血的经济成本：澳大利亚一家三级医院的病例对照研究
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016032.75207.94
N. Young, J. Quinlivan, R. Fox, J. Anderson, L. Davis, S. Mooney
{"title":"Economic Cost of Secondary Postpartum Hemorrhage: A Case-Control Study at a Tertiary Hospital in Australia","authors":"N. Young, J. Quinlivan, R. Fox, J. Anderson, L. Davis, S. Mooney","doi":"10.1097/01.aoa.0001016032.75207.94","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016032.75207.94","url":null,"abstract":"(Aust N Z J Obstet Gynaecol. 2023;63:308–313)\u0000 Secondary postpartum hemorrhage (PPH) is excessive vaginal bleeding occurring up to 12 weeks after childbirth. The incidence ranges from 0.2% to 3.0%, usually presenting 1 to 2 weeks postnatally and commonly caused by endometritis and retained products. Despite its impact on health, evidence for managing and understanding its cost burden is lacking compared with primary PPH. Australian public hospitals are subsidized, but reproductive care costs were $8.7B in 2018 to 2019. Effective resource allocation is vital amidst rising health care expenses. Limited evidence guides secondary PPH treatment, potentially leading to multiple presentations and increased costs. Consequences include resuscitation, transfusion, surgery, and hysterectomy, elevating health care expenses. This study sought to analyze the economic impact of secondary PPH.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"6 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099327","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
Common Street Drug Names for the Anesthesiologist and Pain Physician 麻醉师和疼痛科医生常用的街头药物名称
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001015936.56586.3c
R.R. Donald, S. Patel, M. Smith, S. Clayton, S. Potru
{"title":"Common Street Drug Names for the Anesthesiologist and Pain Physician","authors":"R.R. Donald, S. Patel, M. Smith, S. Clayton, S. Potru","doi":"10.1097/01.aoa.0001015936.56586.3c","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015936.56586.3c","url":null,"abstract":"(Reg Anesth Pain Med. 2023;48(7):365–374)\u0000 Over the years, many drugs have acquired colloquial “street names” in addition to their official designations. Familiarizing medical professionals, including anesthesiologists, with these slang terms can be crucial for effective patient care. Some drugs are named based on their physical appearance or packaging, which may differ from their clinical labels. This allows drug users and dealers to discuss substances discreetly in everyday conversation. Therefore, having a comprehensive list of street names associated with various drugs is essential for health care providers to ensure patient safety and provide appropriate care.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100224","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
Hyperemesis Gravidarum: Associations With Personal and Family History of Nausea 孕吐：与个人和家族恶心病史的关系
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016004.94884.53
V. Lindström, L. Laitinen, J. Nurmi, M. Koivisto, P. Polo-Kantola
{"title":"Hyperemesis Gravidarum: Associations With Personal and Family History of Nausea","authors":"V. Lindström, L. Laitinen, J. Nurmi, M. Koivisto, P. Polo-Kantola","doi":"10.1097/01.aoa.0001016004.94884.53","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016004.94884.53","url":null,"abstract":"(Acta Obstet Gynecol Scand. 2023;102:1176–1182)\u0000 Nausea and vomiting are prevalent in early pregnancy, with 3.6% experiencing severe symptoms termed hyperemesis gravidarum (HG). Characterized by early onset, impaired eating, and impactful daily life restrictions, HG leads to dehydration and weight loss, becoming a primary cause for early pregnancy hospitalization. Unfortunately, health care recognition of HG is insufficient, resulting in underdiagnosis and undertreatment. The condition’s multifactorial origins include vestibular, olfactory, hormonal, and gastrointestinal factors. General nausea links to various situations and a family history of HG suggests a genetic component. Research indicates that women with a history of nausea may be more susceptible to HG. Identifying such connections can aid health care professionals in recognizing and managing HG risk.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"14 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100461","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
Quality of Recovery Following Childbirth: A Prospective, Multicenter Cohort Study 产后恢复的质量：一项前瞻性多中心队列研究
Obstetric Anesthesia Digest Pub Date : 2024-05-24 DOI: 10.1097/01.aoa.0001016128.61922.e0
J. O'Carroll, L. Zucco, E. Warwick, G. Arbane, S. R. Moonesinghe, K. El-Boghdadly, N. Guo, B. Carvalho, P. Sultan
{"title":"Quality of Recovery Following Childbirth: A Prospective, Multicenter Cohort Study","authors":"J. O'Carroll, L. Zucco, E. Warwick, G. Arbane, S. R. Moonesinghe, K. El-Boghdadly, N. Guo, B. Carvalho, P. Sultan","doi":"10.1097/01.aoa.0001016128.61922.e0","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016128.61922.e0","url":null,"abstract":"(Anaesthesia. 2023;78(9):1071–1080)\u0000 The peripartum period, encompassing childbirth and its aftermath, involves the administration of anesthesia or analgesia to ∼65% of patients, a substantial portion necessitated by urgent surgical interventions. The imperative to enhance surgical recovery and ensure patient satisfaction postpartum is crucial for delivering high-quality clinical care, as it has the potential to positively influence maternal physical and psychological well-being. Despite the escalating focus on postpartum-related research, prior studies on recovery have been predominantly confined to single-center endeavors with limited sample sizes, deploying disparate outcome measures or unvalidated metrics, primarily evaluating inpatient recovery with insufficient scrutiny of outpatient recovery.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099157","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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