Acute starvation in pregnancy: a cause of severe metabolic acidosis.


:We report a case of starvation-induced metabolic ketoacidosis in a previously healthy 29-year-old, nulliparous woman at 32 weeks of gestation. She was admitted to hospital with mild preeclampsia associated with persistent nausea and vomiting that progressed to severe preeclampsia requiring urgent control of hypertension before caesarean delivery. Prolonged and severe vomiting limited oral caloric intake and led to starvation ketoacidosis, characterised by ketonuria and a raised anion gap metabolic acidosis that required intensive care support. Despite significant metabolic derangement the patient appeared clinically well. Intravascular volume was replenished. Fluid restriction used as part of our preeclampsia treatment regimen delayed the therapeutic administration of sufficient dextrose, which rapidly corrected her metabolic derangement when commenced after delivery. Electrolyte supplementation was given to prevent re-feeding syndrome. Both mother and baby were discharged without sequelae.


Int J Obstet Anesth


Patel A,Felstead D,Doraiswami M,Stocks GM,Waheed U




Has Abstract


2011-07-01 00:00:00














  • Assessment of knowledge regarding cardiopulmonary resuscitation of pregnant women.

    abstract:INTRODUCTION:The 2000-2002 triennial UK Report on Confidential Enquiries into Maternal Deaths concluded that over 50% of maternal deaths involved substandard care and that many could have been prevented. Catastrophic events leading to cardio-respiratory arrest may necessitate the resuscitation of pregnant women in vari...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Cohen SE,Andes LC,Carvalho B

    更新日期:2008-01-01 00:00:00

  • Blood conservation techniques in obstetrics: a UK perspective.

    abstract::In the UK, maternal mortality due to haemorrhage appears to be rising, with obstetric haemorrhage accounting for 3-4% of the red cells transfused. Allogeneic blood transfusion carries risks such as administration errors, transmitted infections and immunological reactions. The supply of blood is decreasing, partly due ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审


    authors: Catling S

    更新日期:2007-07-01 00:00:00

  • Total intravenous anesthesia for evacuation of a hydatidiform mole and termination of pregnancy in a patient with thyrotoxicosis.

    abstract::Clinical hyperthyroidism is found in approximately 5% of women with a hydatidiform mole, as human chorionic gonadotropin secreted by molar tissue is structurally similar to thyroid-stimulating hormone. A hydatidiform mole occasionally presents with a co-existing viable fetus. Surgical evacuation may be indicated for s...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Erturk E,Bostan H,Geze S,Saracoglu S,Erciyes N,Eroglu A

    更新日期:2007-10-01 00:00:00

  • The incidence of maternal fever during labor is less with intermittent than with continuous epidural analgesia: a randomized controlled trial.

    abstract:BACKGROUND:This prospective, randomized study was performed to see if intermittent labor epidural analgesia was protective against maternal intrapartum fever, compared to continuous epidural infusion. METHODS:Ninety-two healthy, term, nulliparous women in spontaneous labor were assigned to either intermittent (ILEA) o...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Mantha VR,Vallejo MC,Ramesh V,Phelps AL,Ramanathan S

    更新日期:2008-04-01 00:00:00

  • Cesarean birth - What's in a name?

    abstract:BACKGROUND:Cesarean birth is known as both cesarean section (CS) and cesarean delivery (CD). The International Journal of Obstetric Anesthesia (IJOA) is the leading obstetric anesthesia journal, and a barometer of attitudes within the profession. The journal recently published the hundredth issue, spanning 25 years (to...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Ni L,Elsaharty A,McConachie I

    更新日期:2018-05-01 00:00:00

  • The use of remifentanil infusion to facilitate epidural catheter placement in a parturient: a case report with pharmacokinetic simulations.

    abstract::We present a case in which remifentanil infusion was used to provide analgesia during epidural catheter placement in a parturient who was experiencing great difficulty staying motionless because of extremely painful uterine contractions. Remifentanil may provide certain advantages in this setting, including improved a...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Brada SA,Egan TD,Viscomi CM

    更新日期:1998-04-01 00:00:00

  • Resident training in obstetric anesthesia in the United States.

    abstract:BACKGROUND:Limited information exists on obstetric anesthesia experience and training within residency training programs in the United States. METHODS:A survey was sent to every academic anesthesiology training program in the United States (n=120), with follow-up reminders to non-responders. The survey included 14 que...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Panni MK,Camann WR,Tsen LC

    更新日期:2006-10-01 00:00:00

  • Undiagnosed raised intracranial pressure complicating labour.

    abstract::A 30-year-old woman was admitted to the labour ward at term complaining of symptoms suggestive of raised intracranial pressure which were overlooked. Epidural analgesia was administered following induction of labour and was associated with a clear exacerbation of symptoms. After delivery a CT scan revealed a large cer...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Wakeling HG,Barry PC

    更新日期:1995-04-01 00:00:00

  • Haemodynamic effects of the position chosen for the insertion of an epidural catheter.

    abstract::An epidural catheter may be inserted with the patient either in the flexed left lateral or the sitting position. We have studied, non-invasively, the haemodynamic changes associated with these positions, using the thoracic bio-impedance method (BOMED NCCOM3 Monitor). Maternal arterial pressure and fetal heart rate wer...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Chadwick IS,Eddleston JM,Chandelier CK,Pollard BJ

    更新日期:1993-01-01 00:00:00

  • Anaesthesia in parturients with heart disease: a five year review in an Australian tertiary hospital.

    abstract::At the Royal Women's Hospital, Queensland, between 1993 and 1997 there were 56 vaginal and 22 caesarean deliveries involving 68 women with heart disease. Over half of those women required anaesthetic input, in particular, the women who had the most serious cardiac compromise. There were two maternal deaths, four unboo...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Boyle RK

    更新日期:2003-07-01 00:00:00

  • Analgesic effects of intrathecal tramadol in patients undergoing caesarean section: a randomised, double-blind study.

    abstract:BACKGROUND:Intrathecal tramadol combined with local anaesthetics has been used for postoperative analgesia following lower abdominal and perineal surgery. The present study evaluated the effect of intrathecal tramadol on spinal block characteristics and neonatal outcome after elective caesarean section. METHODS:Eighty...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Subedi A,Biswas BK,Tripathi M,Bhattarai BK,Pokharel K

    更新日期:2013-11-01 00:00:00

  • Low-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial.

    abstract:BACKGROUND:Ketamine at subanesthetic doses has analgesic properties that have been shown to reduce postoperative pain and morphine consumption. We hypothesized that intravenous ketamine 10mg administered during spinal anesthesia for cesarean delivery, in addition to intrathecal morphine and intravenous ketorolac, would...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Bauchat JR,Higgins N,Wojciechowski KG,McCarthy RJ,Toledo P,Wong CA

    更新日期:2011-01-01 00:00:00

  • A randomized controlled trial comparing Ametop™ with placebo for reducing pain associated with local anesthetic skin infiltration before neuraxial anesthesia in parturients.

    abstract:BACKGROUND:Between 10-22% of the general population experience needle phobia. Needle phobic parturients are at increased risk of adverse outcomes. We assessed the efficacy of topical Ametop™ (tetracaine 4%) gel in reducing the pain associated with local anesthetic skin infiltration before neuraxial block in non-laborin...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Kavanagh T,Dube A,Albert A,Gunka V

    更新日期:2016-08-01 00:00:00

  • Untoward incident reporting in obstetric anaesthesia: a 6-month prospective study in Northern Ireland.

    abstract::The marked reduction in the number of cases related to the provision of anaesthesia, included in the triennial Reports on Confidential Enquiries into Maternal Deaths in the UK, may limit the educational value of such reports for anaesthetists in the future. The collection, analysis and reporting of untoward events rel...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: McBrien ME,Bali IM

    更新日期:1996-10-01 00:00:00

  • Subcapsular liver hematoma causing cardiac tamponade in HELLP syndrome.

    abstract::HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome is an obstetric complication with heterogeneous presentation, multisystem involvement and variable prognosis, but which usually resolves after delivery. We report a case of HELLP syndrome with subcapsular hematoma of the liver causing extrapericardia...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Kinthala S,Fakoory M,Greaves T,Kandamaran L,Thomas H,Moe S

    更新日期:2012-07-01 00:00:00

  • A United Kingdom national obstetric intubation equipment survey.

    abstract:BACKGROUND:Failed intubation is relatively common in the obstetric patient. Overall, there has been a decline in experience of general anaesthesia in obstetrics. The level of anaesthetic preparedness in the event of a difficult obstetric intubation is unknown. METHODS:With approval from the Obstetric Anaesthetists' As...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Bullough AS,Carraretto M

    更新日期:2009-10-01 00:00:00

  • Anaesthetic management of an obstetric patient with Pompe disease.

    abstract::Pompe disease (Glycogen storage disease type II) leads to abnormal glycogen deposition in various vital organs resulting in multiple systemic sequelae. We present the anaesthetic management for caesarean section of a 31-year-old parturient with known Pompe disease. The parturient had symptoms and signs of respiratory ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Cilliers HJ,Yeo ST,Salmon NP

    更新日期:2008-04-01 00:00:00

  • Prophylactic infusion of phenylephrine is effective in attenuating the decrease in regional cerebral blood volume and oxygenation during spinal anesthesia for cesarean section.

    abstract:BACKGROUND:Hypotension induced by spinal anesthesia for cesarean section causes a decrease in maternal regional cerebral blood volume and oxygenation. We used near-infrared spectroscopy to determine whether prophylactic infusion of phenylephrine attenuates these decreases. METHODS:Sixty patients undergoing bupivacaine...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验


    authors: Hirose N,Kondo Y,Maeda T,Matsui M,Matsuda M,Suzuki T

    更新日期:2019-02-01 00:00:00

  • Cardiogenic shock following cesarean delivery due to undiagnosed tuberculous constrictive pericarditis.

    abstract::We describe an uncommon cause of cardiogenic shock following cesarean delivery in a 24-year-old multiparous woman at 26 weeks of gestation. Hemodynamic instability was erroneously attributed to amniotic infection syndrome and sepsis, which resulted in delayed diagnosis and treatment of tuberculous constrictive pericar...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Brendt P,Herbstreit F,Peters J

    更新日期:2010-10-01 00:00:00

  • Cesarean section and primary pulmonary hypertension: the role of intravenous dexmedetomidine.

    abstract::Primary pulmonary hypertension is a fatal disease that frequently becomes evident in pregnancy. The management of pregnant women with primary pulmonary hypertension poses a number of difficult problems, especially where regional anesthesia is considered to be contraindicated. A 30-year-old woman who developed primary ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Toyama H,Wagatsuma T,Ejima Y,Matsubara M,Kurosawa S

    更新日期:2009-07-01 00:00:00

  • Catheter failure rates and time course with epidural versus combined spinal-epidural analgesia in labor.

    abstract:BACKGROUND:The combined spinal-epidural technique for labor analgesia has several advantages over the traditional epidural technique, including faster onset, greater maternal satisfaction, and decreased need for physician boluses. Proponents of the epidural technique criticize the combined spinal-epidural technique, ar...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Groden J,Gonzalez-Fiol A,Aaronson J,Sachs A,Smiley R

    更新日期:2016-05-01 00:00:00

  • Anesthesia for non-obstetric surgery during pregnancy in a tertiary referral center: a 16-year retrospective, matched case-control, cohort study.

    abstract:INTRODUCTION:This retrospective, matched case-control cohort study describes the incidence, indications, anesthesia techniques and outcomes of pregnancies complicated by surgery in a single tertiary-referral hospital. METHODS:Retrospective review of the hospital records of 171 patients who had non-obstetric surgery in...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Devroe S,Bleeser T,Van de Velde M,Verbrugge L,De Buck F,Deprest J,Devlieger R,Rex S

    更新日期:2019-08-01 00:00:00

  • General anesthesia for cesarean section in a Singapore maternity hospital: a retrospective survey.

    abstract::We conducted a retrospective study of all cases of cesarean section at the KK Women's and Children's Hospital over a one-year period from September 1, 2002 to August 31, 2003, with the aim of evaluating current anesthetic practice. These cases were identified using hospital databases and relevant data was extracted fr...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Kan RK,Lew E,Yeo SW,Thomas E

    更新日期:2004-10-01 00:00:00

  • High dose alfentanil as sole anaesthetic induction agent for caesarean section in a patient with severe ischaemic heart disease.

    abstract::A 43-year-old woman presented at 34 weeks' gestation with pre-eclampsia and intra-uterine growth restriction. She had a past medical history of myocardial infarction and had angina on moderate effort. She also had non-insulin dependent diabetes mellitus, chronic obstructive airways disease and hypercholesterolaemia. T...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Duggan M,Carey M

    更新日期:2000-07-01 00:00:00

  • Amniotic fluid embolism during caesarean section.

    abstract::Amniotic fluid embolism occurs rarely but is a leading cause of maternal mortality. A high index of clinical suspicion is necessary to make an early diagnosis to reduce morbidity and mortality. We report a non-fatal case of amniotic fluid embolism occurring during a caesarean section, with special emphasis on the mode...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Tramoni G,Valentin S,Robert MO,Sergeant MV,Branche P,Duperret S,Clement HJ,Lopez F,Boisson C,Audra P,Rudigoz RC,Viale JP

    更新日期:2004-10-01 00:00:00

  • An educational intervention about the classification of penicillin allergies: effect on the appropriate choice of antibiotic therapy in pregnant women.

    abstract:BACKGROUND:Most pregnant women who self-report penicillin allergy are not truly penicillin-allergic and this misunderstanding often leads to administration of inappropriate antibiotic therapy. Decision algorithms have been developed to guide antibiotic selection but major discrepancies have been reported between guidel...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Thellier C,Subtil D,Pelletier de Chambure D,Grandbastien B,Catteau C,Beaugendre A,Poitrenaud D,Prevotat A,Richart P,Faure K,Le Guern R

    更新日期:2020-02-01 00:00:00

  • Temporizing treatment for the respiratory-compromised gravida: an observational study of maternal and neonatal outcome.

    abstract::Acute lung disease may originate in pregnancy because of the pregnancy itself or because of an intercurrent etiology. The purpose of this study was to describe the effect of prolonged antepartum mechanical ventilatory support on the mother and the neonate when the strategy was to prolong the pregnancy rather than deli...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Grisaru-Granovsky S,Ioscovich A,Hersch M,Schimmel M,Elstein D,Samueloff A

    更新日期:2007-07-01 00:00:00

  • Arnold-Chiari malformation and pregnancy.

    abstract::Chiari (or Arnold-Chiari) malformations are a continuum of abnormalities of the hindbrain with the possibility of disordered cerebrospinal fluid flow and craniospinal pressure gradients. We describe the management of a 30-year-old primigravida who presented following a grand mal seizure during the first trimester. A C...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Penney DJ,Smallman JM

    更新日期:2001-04-01 00:00:00

  • The use of fibrinogen concentrate to correct hypofibrinogenaemia rapidly during obstetric haemorrhage.

    abstract::Haemorrhage is a common complication of childbirth with 0.65% of deliveries associated with significant (>1500 mL) peripartum blood loss. Hypofibrinogenaemia secondary to dilutional and consumptive coagulopathies can be challenging to correct quickly with conventional blood and plasma therapy. Fibrinogen concentrate o...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Bell SF,Rayment R,Collins PW,Collis RE

    更新日期:2010-04-01 00:00:00

  • Spontaneous intracranial hypotension--lessons to be learned for the investigation of post dural puncture headache.

    abstract::We describe a case of spontaneous intracranial hypotension in a 36-year-old woman. This condition shares many of the features of post dural puncture headache, but without a dural puncture having been performed. The aetiology and management of this rare condition are discussed. We believe from experience within our own...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章


    authors: Adams MG,Romanowski CA,Wrench IJ

    更新日期:2002-01-01 00:00:00