AJP Reports最新文献

{"title":"Limitations of Gravimetric Quantitative Blood Loss during Cesarean Delivery.","authors":"Robert L Thurer,&nbsp;Sahar Doctorvaladan,&nbsp;Brendan Carvalho,&nbsp;Andrea T Jelks","doi":"10.1055/s-0041-1742267","DOIUrl":"https://doi.org/10.1055/s-0041-1742267","url":null,"abstract":"<p><p><b>Objective</b>  This study examined the accuracy, sources of error, and limitations of gravimetric quantification of blood loss (QBL) during cesarean delivery. <b>Study Design</b>  Blood loss determined by assays of the hemoglobin content on surgical sponges and in suction canisters was compared with QBL in 50 parturients. <b>Results</b>  QBL was moderately correlated to the actual blood loss ( <i>r</i>  = 0.564; <i>p</i>  < 0.001). Compared with the reference assay, QBL overestimated blood loss for 44 patients (88%). QBL deviated from the assayed blood loss by more than 250 mL in 34 patients (68%) and by more than 500 mL in 16 cases (32%). Assayed blood loss was more than 1,000 mL in four patients. For three of these patients, QBL was more than 1,000 mL (sensitivity = 75%). QBL was more than 1,000 mL in 12 patients. While three of these had an assayed blood loss of more than 1,000 mL, 9 of the 46 patients with blood losses of less than 1,000 mL by the assay (20%) were incorrectly identified as having postpartum hemorrhage by QBL (false positives). The specificity of quantitative QBL for detection of blood loss more than or equal to 1,000 mL was 80.4%. <b>Conclusion</b>  QBL was only moderately correlated with the reference assay. While overestimation was more common than underestimation, both occurred. Moreover, QBL was particularly inaccurate when substantial bleeding occurred. <b>Key Points</b> QBL is inaccurate in cesarean delivery.QBL deviated from the assay result by more than 500 mL in 32% of cases.QBL sensitivity and specificity for hemorrhage is 75.0% (95% confidence interval [CI]: 0.19-0.93) and 80.4% (95% CI: 0.69-0.92), respectively.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e36-e40"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/83/10-1055-s-0041-1742267.PMC8816625.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the Degree of Maternal Fever in the Setting of Chorioamnionitis Lead to Adverse Neonatal Outcomes?","authors":"Megan S Varvoutis,&nbsp;Azza E Abdalla,&nbsp;Sarah K Dotters-Katz","doi":"10.1055/s-0041-1742269","DOIUrl":"https://doi.org/10.1055/s-0041-1742269","url":null,"abstract":"<p><p><b>Objective</b>  The effect of the degree of maternal fever in the setting of chorioamnionitis on neonatal morbidity is unclear. The objective of this study is to assess the association between high maternal fevers (≥ 39°C) on neonatal morbidity. <b>Study Design</b>  Secondary analysis of Maternal-Fetal Medicine Units (MFMU) Cesarean Registry data obtained from 1999 to 2002 among singleton gestations with chorioamnionitis. Women with a temperature less than 39°C (low fever) compared with those with greater than or equal to 39°C (high fever). Primary outcome was a composite of adverse neonatal outcomes such as death, sepsis, necrotizing enterocolitis, grade-3 or -4 intraventricular hemorrhage, seizure within 24 hours of delivery, intubation within 24 hours of delivery, and requiring cardiopulmonary resuscitation. Demographic characteristics compared using Fisher's exact and Wilcoxon's rank-sum test as appropriate. Multivariate logistic regression analysis with performed to control for cofounders. Stratified analysis also performed to assess outcomes in term infants. <b>Results</b>  Of 1,313 included women, 1,200 (91.3%) were in the low fever group and 113 (8.7%) were in the high fever group. Women in the high fever group were more likely to be African American and group B <i>Streptococcus</i> positive. No difference in primary outcome was noted between the groups (38.9% high fever vs. 35.8% low fever, <i>p</i>  = 0.54). High maternal fever was associated with increased risk of NICU admission (48.1 vs. 50.4%, <i>p</i>  = 0.02). When controlling for African American race, preterm birth, and delivery route, patients with high fever were not more likely to have adverse neonatal outcomes (adjusted odds ratio [aOR] = 1.28, 95% confidence interval [CI]: 0.84, 1.98). In the analysis limited to term infants, when controlling for confounders, high fever, similarly, was not associated with increased odds of adverse neonatal outcomes (aOR = 1.59, 95% CI: 0.96, 2.65). <b>Conclusion</b>  The degree of maternal fever does not appear to be associated with an increased likelihood of adverse neonatal outcomes. Better understanding maternal factors that affect neonatal morbidity in the setting of chorioamnionitis is critical. <b>Key Points</b> High maternal fever in the setting of chorioamnionitis does not appear to have an increased likelihood of adverse neonatal outcomes.It is important to identify factors that may increase the risk of adverse outcomes such as early onset sepsis.Maternal fever may not be a strong indicator for neonatal outcomes and antibiotic protocols.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e58-e63"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/4e/10-1055-s-0041-1742269.PMC8816624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19-Associated Coagulopathy in the Peripartum Setting: A Case Report.","authors":"Ashley Allen,&nbsp;Christine Hoang,&nbsp;Roopina Sangha","doi":"10.1055/s-0041-1742237","DOIUrl":"https://doi.org/10.1055/s-0041-1742237","url":null,"abstract":"<p><p>Sepsis-induced coagulopathy (SIC) scoring and D-dimer can be used to recognize COVID-19-induced coagulopathy, but the utility of these is largely unknown in the peripartum setting and leaves anticoagulation guidance unclear. We present the case of a critically ill postpartum patient with COVID-19 infection. This patient presented with clinical signs of COVID-19 infection and developed acute respiratory failure requiring invasive mechanical ventilation and subsequent cesarean delivery at 34 weeks. She initially improved postoperatively but deteriorated after postoperative day 5. She was found to have a very elevated D-dimer of 58 μg/mL and anticoagulation was escalated to full dosing. She required prolonged mechanical ventilation and deceased after developing gram-positive cocci bacteremia. This case demonstrates that recognition and management of COVID-19-associated coagulopathy can be confusing in the peripartum period and studies are needed to validate D-dimer and SIC scoring in this population of patients.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e33-e35"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/7a/10-1055-s-0041-1742237.PMC8816627.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconception Counseling: Identifying Ways to Improve Services.","authors":"Khyla Burrows,&nbsp;Jeanelle Sheeder,&nbsp;Virginia Lijewski,&nbsp;Teresa Harper","doi":"10.1055/s-0041-1742272","DOIUrl":"https://doi.org/10.1055/s-0041-1742272","url":null,"abstract":"<p><p><b>Objective</b>  The aim of this retrospective study was to evaluate the maternal conditions for which preconception services are provided and the routine services and recommendations offered through the Maternal Fetal Medicine group at the University of Colorado (CU). The study sought to determine how services and recommendations differ by maternal condition, demographics, and reproductive health history. <b>Materials and Methods</b>  Charts of patients who received preconception counseling through the CU MFM department during 2018 were reviewed to evaluate maternal conditions and the type of counseling patients received. Patients were grouped by their referral reason and subsequently by counseling recommendations to either proceed with immediate conception, defer immediate conception pending completion of further recommendations or to not conceive. <b>Results</b>  Of the fifty-nine patients referred to preconception counseling, 52% ( <i>n</i> = 31) of the women were referred for maternal disease, 40% ( <i>n</i> = 24) for infertility, 32% ( <i>n</i> = 19) for previous poor obstetric outcomes, 30% ( <i>n</i> = 18) for advanced maternal age and finally, 15% ( <i>n</i> = 9) for gynecologic anatomic abnormalities. <b>Conclusion</b>  During the initial evaluation, 58% ( <i>n</i> = 34) of patients were determined to have no concern for immediate conception while 7% ( <i>n</i> = 4) were ultimately advised to not conceive. Using this data, we identified areas of preconception counseling that standardization will improve by ensuring patients receive comparable services and advice.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e49-e57"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/d5/10-1055-s-0041-1742272.PMC8816632.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside Ultrasonography in Evaluating Mediastinum Leakage in an Extremely-Low-Birth-Weight Infant with Esophageal Perforation.","authors":"Mitsuhiro Haga,&nbsp;Yumiko Sato,&nbsp;Tomo Kakihara,&nbsp;Wakako Sumiya,&nbsp;Masayuki Kanno,&nbsp;Tetsuya Ishimaru,&nbsp;Masaki Shimizu,&nbsp;Hiroshi Kawashima","doi":"10.1055/s-0041-1741538","DOIUrl":"https://doi.org/10.1055/s-0041-1741538","url":null,"abstract":"<p><p>Esophageal perforation in premature infants is a life-threatening condition that requires prompt treatment. Contrast-enhanced computed tomography (CECT) is recommended for diagnosis. However, it is difficult to obtain CECT images in premature infants because of their unstable conditions. We encountered a case of esophageal perforation in an extremely-low-birth-weight female infant. Bedside ultrasonography was useful in the diagnosis and follow-up evaluation of leakage in the mediastinum. Ultrasonography can be a useful modality for the evaluation of perforation of the lower part of the esophagus in premature infants.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e76-e79"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/fc/10-1055-s-0041-1741538.PMC8816637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal Sonographic Assessment Following Cervical Pessary Placement for Preterm Birth Prevention.","authors":"William Schnettler,&nbsp;Shwetha Manoharan,&nbsp;Kate Smith","doi":"10.1055/s-0041-1742273","DOIUrl":"https://doi.org/10.1055/s-0041-1742273","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background&lt;/b&gt;  Transvaginal sonographic cervical length assessment identifies pregnant women at risk for preterm birth, and the subsequent placement of a cervical pessary may reduce this risk. The mechanism of action remains uncertain, and postplacement transvaginal sonography may provide further insight into the controversial efficacy of this therapy. &lt;b&gt;Objective&lt;/b&gt;  To identify any pre- or postplacement sonographic findings associated with preterm delivery following cervical pessary insertion among at-risk women. &lt;b&gt;Materials and Methods&lt;/b&gt;  This retrospective cohort study utilized electronic medical record and imaging review of all women identified within a large tertiary care health system having undergone cervical pessary placement for preterm birth risk reduction and subsequently delivered between January 2013 (the adoption of this therapeutic option in our system) and March 2017. Indications for cervical pessary placement were guided by maternal-fetal medicine consultation and required a functional cervical length measurement on transvaginal sonography of 25 mm or less. Criteria for initial transvaginal cervical assessment included obstetric history, multiple gestation, and current concern on transabdominal imaging for cervical shortening. All pre- and postplacement transvaginal sonographic measurements were determined for study purposes by re-review of each patient's images by a single author blinded to outcome. &lt;b&gt;Results&lt;/b&gt;  A total of 88 women were identified as having undergone cervical pessary placement for preterm birth prevention, and 52 yielded complete delivery and imaging data for inclusion. As expected, this was a high-risk population with 51.9% carrying multiple gestations, 32.7% with a history of prior preterm birth, and 11.6% with a history of cervical conization. Although previously hypothesized to represent the mechanism of action, neither the change in uterocervical or intracervical angle was associated with gestational age at delivery. Alternatively, preplacement imaging measurements of cervical funneling, anterior cervical length, and cervical diameter were significantly associated with appropriate pessary placement and decreased preterm birth. Forty-two subjects (80.8%) demonstrated both the anterior and posterior aspects of the cervix within the pessary (appropriate placement) and 95.2% of these subjects demonstrated cervical funneling on initial imaging compared with 25% of those with inappropriate placement ( &lt;i&gt;p&lt;/i&gt;  = 0.002). Anterior cervical length less than 20 mm and cervical diameter less than 33 mm were associated with preterm delivery less than 28 weeks (16.7 vs. 0%, &lt;i&gt;p&lt;/i&gt;  = 0.039), and anterior cervical length less than 20 mm was associated with preterm delivery less than 32 weeks (41.7 vs. 10.7%, &lt;i&gt;p&lt;/i&gt;  = 0.025). Cervical diameter less than 33 mm correlated with an \"inappropriately placed\" pessary among 83.3% in comparison to 48.7% ( &lt;i&gt;p&lt;/i&gt;  = 0.048) of women with a cervical diamete","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e80-e88"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/59/10-1055-s-0041-1742273.PMC8816641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Loop Electrosurgical Excision Procedure and Cone Conundrum: The Role of Cumulative Excised Depth in Predicting Preterm Birth.","authors":"Danielle M Panelli,&nbsp;Rachel L Wood,&nbsp;Kevin M Elias,&nbsp;Whitfield B Growdon,&nbsp;Anjali J Kaimal,&nbsp;Sarah Feldman,&nbsp;Thomas F McElrath","doi":"10.1055/s-0041-1742271","DOIUrl":"https://doi.org/10.1055/s-0041-1742271","url":null,"abstract":"<p><p><b>Objective</b>  The objective was to determine factors associated with spontaneous preterm birth at less than 37 weeks in a cohort of patients who underwent a loop electrosurgical excision procedure (LEEP) or cone prior to pregnancy. <b>Study Design</b>  This was a nested case-control study within a cohort of patients who underwent at least one LEEP or cone and had care for the next singleton pregnancy at either of two institutions between 1994 and 2014. Cases had spontaneous preterm birth at less than 37 weeks. Exposures included potential risk factors for preterm birth such as cumulative depth of excised cervix and time since excision. Reverse stepwise selection was used to identify the covariates for multivariable logistic regression. <b>Results</b>  A total of 134 patients were included. Eighteen (13%) had a spontaneous preterm birth at less than 37 weeks. Median second-trimester cervical lengths were similar between those who delivered preterm and term (3.9-cm preterm and 3.6-cm term, <i>p</i>  = 0.69). Patients who delivered preterm had a significantly greater median total excised depth of cervix (1.2 vs. 0.8 cm, <i>p</i>  = 0.04). After adjustment for confounders, total excised depth remained significantly associated with preterm birth (adjusted odds ratio [aOR] = 2.2, 95% confidence interval [CI]: 1.3-3.8). <b>Conclusion</b>  Total excised depth should be considered in addition to cervical length screening when managing subsequent pregnancies. <b>Key Points</b> A history of a LEEP or cone excision has been associated with spontaneous preterm birth.A two-fold increase in spontaneous preterm birth was seen per cumulative centimeter excised.There was no difference in second-trimester cervical length between the term and preterm groups.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e41-e48"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/42/10-1055-s-0041-1742271.PMC8816626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Respiratory Compromise following Cesarean Birth: The Impact of Obesity and Systemic Opioids.","authors":"Jessica L Walker, Jacquelyn H Adams, Aimee T Broman, Peter G Pryde, Kathleen M Antony","doi":"10.1055/s-0041-1741539","DOIUrl":"10.1055/s-0041-1741539","url":null,"abstract":"<p><p><b>Objective</b>  The aim of this study was to measure the effect of obesity and systemic opioids on respiratory events within the first 24 hours following cesarean. <b>Methods</b>  Opioid-naive women undergoing cesarean between January 2016 and December 2017 were included in this retrospective cohort study. The primary outcome was the proportion of women experiencing at least one composite respiratory outcome (oxygen saturation less than 95% lasting 30+ seconds or need for respiratory support) within 24 hours of cesarean. The impact of obesity and total systemic opioid dose in 24 hours (measured in morphine milligram equivalents [MMEs]) on the composite respiratory compromise outcome were evaluated. <b>Results</b>  Of 2,230 cesarean births, 790 women had at least one composite respiratory event. Predictors of the composite respiratory outcome included body mass index (BMI) as a continuous variable (odds ratio = 1.063 for every one unit increase in BMI [95% confidence interval (CI): 1.021-1.108], <i>p</i>  = 0.003), and MME (odds ratio = 1.005 [95% CI: 1.002-1.008], <i>p</i>  = 0.003), adjusting for magnesium sulfate use. The interaction between obesity and opioid dose demonstrated an odds ratio of 1.000 (95% CI: 0.999-1.000, <i>p</i>  = 0.030). <b>Conclusion</b>  The proportion of women experiencing respiratory events following cesarean birth increases with the degree of obesity and opioid dose. <b>Key Points</b> Respiratory events increase with obesity.Respiratory events increase with systemic opioid use.Odds ratio of respiratory events is 1.063/unit BMI increase.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e1-e9"},"PeriodicalIF":0.8,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/a3/10-1055-s-0041-1741539.PMC8758249.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39825679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Presentation of Limb–Body Wall Complex in a Neonate: Case Report and Review of Literature","authors":"Omoloro Adeleke, Farrukh Gill, R. Krishnan","doi":"10.1055/s-0042-1744215","DOIUrl":"https://doi.org/10.1055/s-0042-1744215","url":null,"abstract":"The Limb Body Wall Complex (LBWC) aka. Body Stalk Syndrome is an uncommon congenital disorder characterized by severe malformations of limb, thorax, and abdomen, characterized by the presence of thoracoschisis, abdominoschisis, limb defects, and exencephaly. This condition is extremely rare with an incidence of 1 per 14,000 and 1 per 31,000 pregnancies in large epidemiologic studies. Majority of these malformed fetuses end up with spontaneous abortions. We present this rare case with occurrence in a preterm infant of 35 weeks gestation. Our report highlights majority of the clinical presentations as reported in previous literature, but the significant pathological findings of absent genitalia and malformed genitourinary, anorectal malformations make this case presentation an even more rare occurrence. Infant karyotyping was normal male and there is no specific underlying genetic correlation in this condition which has fatal prognosis.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"22 1","pages":"e108 - e112"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77895525","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}

{"title":"Perinatal Carbon Monoxide Poisoning: Treatment of a 2-Hour-Old Neonate with Hyperbaric Oxygen","authors":"A. Kreshak, S. Lawrence, Sam T. Ontiveros, Tiffany Castellano, Karen B. VanHoesen","doi":"10.1055/s-0042-1744216","DOIUrl":"https://doi.org/10.1055/s-0042-1744216","url":null,"abstract":"A 41-year-old gravida 4 para 3 (G4P3) and 38 5/7 weeks pregnant woman presented to labor and delivery with dizziness, headache, and decreased fetal movement after 12 hours of exposure to carbon monoxide (CO) from a grill that was used inside for heat. The mother was hemodynamically stable, and her neurologic examination was intact. Her carboxyhemoglobin level, which was obtained 12 hours after removal from the CO exposure, was 7.4%. The fetus's heart rate was 173 beats per minute with moderate variability and one late appearing deceleration, not associated with contractions. The biophysical profile score was 2 of 8. The obstetrics team performed a routine cesarean section. The 1- and 5-minute Apgar's scores were 7 and 8, respectively. The arterial cord gas result was as follows: pH = 7.05, PCO 2  = 71 mm Hg, pO 2  = 19 mm Hg, bicarbonate = 14 mmol/L, and carboxyhemoglobin = 11.9%. The mother and infant were treated with hyperbaric oxygen therapy consisting of 100% oxygen at 2.4 atmosphere absolutes (ATA) for 90 minutes at 2.5 hours after delivery. Following one hyperbaric oxygen treatment, the infant was transitioned to room air and routine postpartum treatment and was discharged 3 days later in good condition. Hyperbaric oxygen treatment was well tolerated in this neonate.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"34 1","pages":"e113 - e116"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90674925","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}