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Risk Factors and Pregnancy Outcomes After SARS-CoV-2 in Pregnancy According to Disease Severity: A Nationwide Cohort Study With Validation of the SARS-CoV-2 Diagnosis 根据疾病严重程度确定妊娠期感染 SARS-CoV-2 后的风险因素和妊娠结局：全国队列研究与 SARS-CoV-2 诊断验证
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005328.85153.05
Anna Aabakke, T.G. Petersen, K. Wøjdemann, M.H. Ibsen, F. Jonsdottir, E. Rønneberg, C.S. Andersen, A. Hammer, T.D. Clausen, J. Milbak, L. Burmester, R. Zethner, B. Lindved, A. Thorsen-Meyer, M.R. Khalil, B. Henriksen, L. Jønsson, LS Andersen, K.K. Karlsen, M. Pedersen, G. Hedermann, M. Vestgaard, D. Thisted, A. N. Fallesen, J. N. Johansson, D. C. Møller, G. Dubietyte, C. Andersson, R. Farlie, A. Skaarup Knudsen, L. Hansen, L. Hvidman, A.N. Sørensen, S. L. Rathcke, K.H. Rubin, L.K. Petersen, J. S. Jorgensen, L. Krebs, M. Bliddal
{"title":"Risk Factors and Pregnancy Outcomes After SARS-CoV-2 in Pregnancy According to Disease Severity: A Nationwide Cohort Study With Validation of the SARS-CoV-2 Diagnosis","authors":"Anna Aabakke, T.G. Petersen, K. Wøjdemann, M.H. Ibsen, F. Jonsdottir, E. Rønneberg, C.S. Andersen, A. Hammer, T.D. Clausen, J. Milbak, L. Burmester, R. Zethner, B. Lindved, A. Thorsen-Meyer, M.R. Khalil, B. Henriksen, L. Jønsson, LS Andersen, K.K. Karlsen, M. Pedersen, G. Hedermann, M. Vestgaard, D. Thisted, A. N. Fallesen, J. N. Johansson, D. C. Møller, G. Dubietyte, C. Andersson, R. Farlie, A. Skaarup Knudsen, L. Hansen, L. Hvidman, A.N. Sørensen, S. L. Rathcke, K.H. Rubin, L.K. Petersen, J. S. Jorgensen, L. Krebs, M. Bliddal","doi":"10.1097/01.aoa.0001005328.85153.05","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005328.85153.05","url":null,"abstract":"(Acta Obstet Gynecol Scand. 2023;102:282–293)\u0000 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to increase a patient’s risk of preterm labor, pre-eclampsia, the need for cesarean delivery, and stillbirth. This study aimed to analyze and better understand the risk factors and complications that relate to SARS-CoV-2 during pregnancy and delivery.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"10 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441056","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
Stalled Progress in Reducing Maternal Mortality Globally: What Next? 全球降低孕产妇死亡率的进展停滞不前：下一步该怎么办？
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005268.10522.a1
C.A. Moyer, E.R. Lawrence, T. Beyuo, M. Tuuli, S.A. Oppong
{"title":"Stalled Progress in Reducing Maternal Mortality Globally: What Next?","authors":"C.A. Moyer, E.R. Lawrence, T. Beyuo, M. Tuuli, S.A. Oppong","doi":"10.1097/01.aoa.0001005268.10522.a1","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005268.10522.a1","url":null,"abstract":"(Lancet. 2023;401(10382):1060–1062. PMID: 36924780)\u0000 According to a report published by the World Health Organization (WHO) in February 2023, the global maternal mortality rate (MMR) improved considerably from 2000 to 2015 (the Millennium Development Goal era). However, from 2016 to 2020, the first 5 years of the Sustainable Development Goal (SDG) era, MMR stagnated or worsened in most regions of the world. During this period, only 2 regions, Australia and New Zealand and Central and Southern Asia, saw reductions in MMR (34.6% and 15.7%, respectively). The highest MMR was in Sub-Saharan Africa, accounting for ~70% of all maternal deaths in 2020.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"32 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439604","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
Staged Treatment of the Placenta Accreta Spectrum: A Combined Surgical and Radiologic Approach 胎盘早剥的分期治疗：手术和放射联合方法
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005380.27358.d7
S. West, A. Martin, R. Copping, G. Gard, R. Maher, S. Seeho
{"title":"Staged Treatment of the Placenta Accreta Spectrum: A Combined Surgical and Radiologic Approach","authors":"S. West, A. Martin, R. Copping, G. Gard, R. Maher, S. Seeho","doi":"10.1097/01.aoa.0001005380.27358.d7","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005380.27358.d7","url":null,"abstract":"(Aust N Z J Obstet Gynaecol. 2023; 63: 372–377)\u0000 The placenta accreta spectrum (PAS) is defined by aberrant placental invasion into the uterine myometrium. Globally, the prevalence of PAS is rising, which affects maternal health outcomes. The depth of invasion into the uterus determines how it is classified, with placenta accreta (villi connecting to the muscle layer), placenta increta (myometrial invasion), and placenta percreta (transmural invasion beyond the serosa) being the most severe. This study evaluated maternal and neonatal outcomes following a combined surgical and interventional radiology (IR) approach for managing the PAS.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"21 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440216","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
Ethical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review 伦理原则不支持强制性麻醉前妊娠筛查试验：叙述性综述
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005300.71572.53
S. Jackson, J. Hunter, G. A. Van Norman
{"title":"Ethical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review","authors":"S. Jackson, J. Hunter, G. A. Van Norman","doi":"10.1097/01.aoa.0001005300.71572.53","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005300.71572.53","url":null,"abstract":"(Anesth Analg. October 6, 2023. doi: 10.1213/ANE.0000000000006669. Online ahead of print)\u0000 The process of informed consent upholds the principle of patient autonomy, rooted in US constitutional principles of privacy and noninterference. It has been legally required in the United States since 1914, ensuring that individuals have the right to determine what happens to their bodies, as Schloendorff v. New York Society Hospital ruled. The recent US Supreme Court decision on abortion has raised concerns about maternal-fetal conflicts and the rights of pregnant patients to undergo elective anesthesia and surgery. Ethical and legal requirements for informed consent in medical testing vary, with challenges in addressing routine laboratory testing. Not all medical tests carry the same ethical implications, but they should all consider beneficence, nonmaleficence, and patient autonomy. Focusing on the need for preanesthesia pregnancy testing remains a concern in anesthesia and surgery practices. The primary premise is preventing harm to the fetus, but this must be supported by medical evidence and adhere to ethical standards. No study conclusively demonstrates that anesthetic agents significantly increase rates of early human fetal loss or malformations. There is no evidence that anesthetic drugs are generally teratogenic or pose a significant risk of harm to the fetus. While such risks are small, they cannot be guaranteed to be absent.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"38 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440330","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
External Validation of a Multivariable Prediction Model for Placenta Accreta Spectrum 胎盘早剥谱多变量预测模型的外部验证
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005376.36999.45
S. Singh, D. Carusi, P. Wang, E. Reitman-Ivashkov, R. Landau, K. Fields, C. Weiniger, M. Farber
{"title":"External Validation of a Multivariable Prediction Model for Placenta Accreta Spectrum","authors":"S. Singh, D. Carusi, P. Wang, E. Reitman-Ivashkov, R. Landau, K. Fields, C. Weiniger, M. Farber","doi":"10.1097/01.aoa.0001005376.36999.45","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005376.36999.45","url":null,"abstract":"(Anesth Analg. 137(3):537–547)\u0000 Placenta accreta spectrum (PAS) encompasses various forms of abnormal placental attachment and uterine invasion. PAS is a leading cause of severe postpartum hemorrhage and often leads to an emergency hysterectomy. Managing PAS and its associated complications, such as preterm birth, maternal morbidity, and neonatal intensive care unit admissions, is best achieved in tertiary-level hospitals equipped with specialized multidisciplinary care. To ensure the highest quality of care, proactive planning is essential. This involves identifying risk factors associated with PAS, facilitating rapid transfers to appropriate delivery facilities, efficient resource allocation, and minimizing the occurrence of life-threatening postpartum hemorrhage and its associated complications.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"37 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440647","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
Current Perspectives on Maternal Critical Care 产妇重症监护的当前视角
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005368.64564.13
K. Cranfield, D. Horner, M. Vasco, G. Victory, D.N. Lucas
{"title":"Current Perspectives on Maternal Critical Care","authors":"K. Cranfield, D. Horner, M. Vasco, G. Victory, D.N. Lucas","doi":"10.1097/01.aoa.0001005368.64564.13","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005368.64564.13","url":null,"abstract":"(Anaesthesia. 2023;78(6):758–769)\u0000 Progress made in reducing maternal mortality rates is plateauing. Projections indicate that maternal mortality rates will reach nearly twice the sustainable development goal of the World Health Organization by 2030. While the reasons for the lack of progress are complex and include factors such as changing maternal demographics and socioeconomic disparities, addressing maternal morbidity is a necessary component of achieving a continuous decrease in maternal mortality. Maternal critical care is an emerging area in obstetrics that will play a crucial role in improving outcomes in maternal morbidity. The recommendations are based on a study in the United Kingdom. However, these principles are likely to be broadly applicable.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"41 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440926","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
Undergraduate Anesthesia Skills for a Global Surgery Agenda: Students’ Self-Reported Competence 全球外科议程的本科生麻醉技能：学生自评能力
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005440.45190.e4
S. Spijkerman, D.M. Manning, L.P. Green-Thompson
{"title":"Undergraduate Anesthesia Skills for a Global Surgery Agenda: Students’ Self-Reported Competence","authors":"S. Spijkerman, D.M. Manning, L.P. Green-Thompson","doi":"10.1097/01.aoa.0001005440.45190.e4","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005440.45190.e4","url":null,"abstract":"(Anesth Analg. 2023. doi: 10.1213/ANE.0000000000006375)\u0000 To address the lack of clear guidelines for undergraduate anesthesia training, this study assessed the self-perceived competence of medical students in South Africa. Maternal mortality is a concern, with a significant portion of deaths attributed to anesthesia. The country faces a shortage of specialist anesthesiologists, putting the responsibility on nonspecialist medical officers, including newly qualified community service officers. The study investigates the readiness of medical students to provide anesthesia services, with varying exposure to training during internships. The findings aim to support South Africa’s health needs and may guide the goals of global surgery in other developing nations.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"10 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441141","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
The Effectiveness of Continuous Positive Airway Pressure for Treating Obstructive Sleep Apnoea in Pregnancy: A Systematic Review 持续气道正压治疗妊娠期阻塞性睡眠呼吸暂停的效果：系统回顾
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005364.90547.dc
R. Nugent, A. Wee, L. Kearney, C. de Costa
{"title":"The Effectiveness of Continuous Positive Airway Pressure for Treating Obstructive Sleep Apnoea in Pregnancy: A Systematic Review","authors":"R. Nugent, A. Wee, L. Kearney, C. de Costa","doi":"10.1097/01.aoa.0001005364.90547.dc","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005364.90547.dc","url":null,"abstract":"(Aust N Z J Obstet Gynaecol 2023. 2023;63(3):290–300)\u0000 Obstructive sleep apnea (OSA) is characterized by recurrent pauses in breathing during sleep due to upper airway collapse, resulting in decreased oxygen levels. OSA affects around 10.5% of parturients during early pregnancy and up to 30% at term. In pregnancy, OSA is associated with an increased risk for gestational hypertension, pre-eclampsia, and gestational diabetes. Infants born to mothers with OSA may have a lower birth weight and are at increased risk for premature delivery and neonatal intensive care unit admission. Baseline obesity increases the risk of OSA during pregnancy, with lifestyle modifications being the standard treatment, though their influence on maternal outcomes is limited. Continuous positive airway pressure (CPAP) is an effective OSA treatment; however, little research exists on the impact of CPAP on either maternal or fetal outcomes. This systematic review sought to investigate if the use of CPAP improved outcomes for pregnant women with or at risk of OSA.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441402","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
Combined Uterorelaxant Effect of Magnesium Sulfate and Terbutaline: Studies on Late Pregnant Rat Uteri In Vitro and In Vivo 硫酸镁和特布他林的联合子宫舒张效应：对妊娠晚期大鼠子宫的体外和体内研究
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005384.33106.8f
T. Barna, K.F. Szucs, A. Schaffer, M. Mirdamadi, J. Hajagos-Toth, R. Gaspar
{"title":"Combined Uterorelaxant Effect of Magnesium Sulfate and Terbutaline: Studies on Late Pregnant Rat Uteri In Vitro and In Vivo","authors":"T. Barna, K.F. Szucs, A. Schaffer, M. Mirdamadi, J. Hajagos-Toth, R. Gaspar","doi":"10.1097/01.aoa.0001005384.33106.8f","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005384.33106.8f","url":null,"abstract":"(Acta Obstet Gynecol Scand. 2023;102:457–464)\u0000 Preterm birth is a common and impactful complication of pregnancy and is defined as the delivery of a fetus between 20 and 37 weeks of gestation. It can lead to further complications and even developmental problems for the child that can be long term. Standard treatment for symptoms of preterm labor involves tocolytic drugs to stop contractions and delay delivery long enough for interventions to occur, minimizing effects on the infant. Although many different drugs are used, the efficacy and side effects of many are not well characterized or understood. This study was designed to assess the effectiveness and side effects of a combination of drugs: β2-agonist terbutaline and magnesium sulfate (MgSO4). This was done by examining the combined administration of the drugs in an isolated organ bath and performing in vivo smooth muscle electromyographic studies in pregnant rats.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"8 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441759","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
Structural Racism and Adverse Pregnancy Outcomes Through the Lens of the Maternal Microbiome 从孕产妇微生物组透视结构性种族主义和不良妊娠结局
Obstetric Anesthesia Digest Pub Date : 2024-02-22 DOI: 10.1097/01.aoa.0001005288.21755.71
M. Hadley, A.Y. Oppong, J. Coleman, A. M. Powell
{"title":"Structural Racism and Adverse Pregnancy Outcomes Through the Lens of the Maternal Microbiome","authors":"M. Hadley, A.Y. Oppong, J. Coleman, A. M. Powell","doi":"10.1097/01.aoa.0001005288.21755.71","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005288.21755.71","url":null,"abstract":"(Obstet Gynecol. 2023;142:911–919)\u0000 Research has clearly shown that health care outcomes are riddled with disparities surrounding race, but arguments exist about whether these disparities are due to biological differences, environmental, structural, or social elements of overall health, or systemic racism and inherent racial bias. Many observed differences in pregnancy outcomes are consistent even when correcting for poverty, educational status, or income level, suggesting that there are other factors that have not yet been identified. This commentary proposes that structural racism is a major contributing factor to health disparities between those of different races, including aspects such as access to healthy food options, psychosocial stressors, and safe and healthy living environments, and these differences will be manifest in the gut and vaginal microbiomes, thus affecting pregnancy-related outcomes related to the microbiome.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"16 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441882","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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