Abstract:
:Cystic fibrosis affects 1 in 1600-2500 live births and is inherited in an autosomal recessive manner. It primarily involves the respiratory, gastrointestinal and reproductive tracts, with impaired clearance of, and obstruction by, increasingly viscous secretions. Severe respiratory disease, diabetes and gastro-oesophageal reflux may result. Improvements in medical management and survival of cystic fibrosis patients means more are committing to pregnancies. Although guidance for anaesthesia in this patient group is available, management and outcome data associated with more severe cases are sparse. Patients with severe cystic fibrosis require multidisciplinary input and should be managed in a tertiary referral centre. Close monitoring of respiratory function and preoperative optimisation during pregnancy are mandatory. The risk of preterm labour and delivery is increased. Pregnancy and delivery can be managed successfully, even in patients with FEV1 <40% predicted. Neuraxial anaesthesia and analgesia should be the technique of choice for delivery. Postoperative care should be carried out in a critical care setting with the provision of postoperative ventilation if necessary.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Deighan M,Ash S,McMorrow Rdoi
10.1016/j.ijoa.2013.10.006subject
Has Abstractpub_date
2014-02-01 00:00:00pages
75-9issue
1eissn
0959-289Xissn
1532-3374pii
S0959-289X(13)00151-9journal_volume
23pub_type
杂志文章abstract:BACKGROUND:Administration of packed red blood cells (PRBC) and fresh frozen plasma (FFP) to women with postpartum hemorrhage (PPH) before and after introduction of a massive transfusion protocol. METHODS:The retrospective PPH study cohort of two tertiary centers was identified using blood bank records, verified by pat...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ijoa.2018.08.001
更新日期:2018-11-01 00:00:00
abstract::Headache is a common puerperal complaint. A wide variety of factors can be involved, ranging from hormonal shifts, physiological changes, and peripartum procedures that may precipitate, worsen, or cause troublesome headache. The differential diagnosis of postpartum headache is broad and potentially daunting to the var...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2010.07.009
更新日期:2010-10-01 00:00:00
abstract::The opioid crisis has reached an unprecedented magnitude in the United States and worldwide, and data on opioid use and misuse in the obstetric population are extremely concerning. Despite an abundant number of studies evaluating strategies to prevent neonatal opioid withdrawal syndrome in babies born to mothers who a...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2019.01.011
更新日期:2019-08-01 00:00:00
abstract::A 34-year-old multiparous woman with a breech presentation, intrauterine growth restriction and premature rupture of membranes was transferred to our referral unit at 33 weeks of gestation. She was diagnosed with Alagille syndrome soon after birth because of cholestasis and pruritus. Her condition was later complicate...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2011.07.012
更新日期:2011-10-01 00:00:00
abstract::We report the case of a 37-year-old postpartum patient who developed a contained subacute spinal subdural hematoma causing mass effect on the cauda equina and severe spinal stenosis after undergoing an epidural blood patch for postdural puncture headache. Recovery occurred following administration of oral steroids. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2011.10.003
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:This systematic review and meta-analysis evaluates evidence for seven risk factors associated with failed conversion of labor epidural analgesia to cesarean delivery anesthesia. METHODS:Online scientific literature databases were searched using a strategy which identified observational trials, published bet...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ijoa.2012.05.007
更新日期:2012-10-01 00:00:00
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
doi:10.1016/j.ijoa.2010.10.002
更新日期:2011-01-01 00:00:00
abstract::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 hypertensi...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2010.11.004
更新日期:2011-07-01 00:00:00
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
doi:10.1016/0959-289x(93)90046-k
更新日期:1993-01-01 00:00:00
abstract::The experiences of 890 parturients were studied across Finland during one week to determine how they experienced labour pain and how effective they regarded the means to alleviate it. The majority of women (72%) had been afraid of labour and 88% had intended to request some pharmacological pain relief. 84% of primipar...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(94)90172-4
更新日期:1994-04-01 00:00:00
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
doi:10.1016/j.ijoa.2004.03.002
更新日期:2004-10-01 00:00:00
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
doi:10.1016/j.ijoa.2009.01.015
更新日期:2009-10-01 00:00:00
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
doi:10.1016/j.ijoa.2018.09.006
更新日期:2019-02-01 00:00:00
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
doi:10.1016/s0959-289x(98)90009-7
更新日期:1998-04-01 00:00:00
abstract::The past two decades has seen a growing understanding that health care leads to harm in a large number of patients. With this insight has come an understanding that clinicians who care for patients who are harmed experience an understandable and predictable emotional response. After an adverse event, medical care give...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2014.10.001
更新日期:2015-02-01 00:00:00
abstract::In order to estimate how long a medication can remain prepared before the integrity or concentration of the drug is compromised, we assessed the sterility and potency of medications commonly used in our obstetric anesthesia practice. Our goal was to evaluate the following drugs over a 30-day period: epinephrine, atrop...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1054/ijoa.2002.0983
更新日期:2002-10-01 00:00:00
abstract::The incidence of obesity in pregnancy has increased rapidly in the last decade. Obesity is a risk factor for venous thromboembolism outside of pregnancy and previous studies of maternal death in the UK have identified obesity as a risk factor in pregnancy. As a result the Royal College of Obstetricians and Gynaecologi...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2012.01.002
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. METHODS:Patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anae...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2018.01.009
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Various interventions are used as prophylaxis for aspiration pneumonitis in obstetric anaesthesia. This review, based on a Cochrane systematic review currently being updated, examines whether interventions given before caesarean section reduce the risk of aspiration pneumonitis. METHODS:Twenty-two studies, ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2010.12.006
更新日期:2011-04-01 00:00:00
abstract::We prospectively studied 30 women in labour who requested epidural analgesia. They were randomly allocated into two groups; one received a preload of 7 mL/kg normal saline and the other no preload. All patients had a standard epidural solution consisting of 0.1% bupivacaine 20 mL containing fentanyl 2 microg/mL. Mean ...
journal_title:International journal of obstetric anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1054/ijoa.2001.0904
更新日期:2001-10-01 00:00:00
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
doi:10.1016/j.ijoa.2019.01.006
更新日期:2019-08-01 00:00:00
abstract::Three cases are described in which epidural analgesia was performed during labour using an infusion of bupivacaine 0.125-0.25%. When, in all 3 cases, caesarean section was required for failure to progress, hyperbaric bupivacaine was given in doses of 10 mg, 12.5 mg and 15 mg respectively. Within 2-4 min all 3 patients...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(94)90229-1
更新日期:1994-07-01 00:00:00
abstract::Current pain and analgesic management strategies apply a standardized one-size-fits-all approach to women undergoing cesarean delivery. These standardized protocols do not account for significant variability in women's pain and may lead to under-treatment in patients with high analgesic needs and overtreatment, associ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2019.02.124
更新日期:2019-11-01 00:00:00
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
doi:10.1054/ijoa.1999.0368
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Epidural analgesia and remifentanil patient-controlled analgesia are two popular techniques for the treatment of labour pain, each with its own efficacy and toxicity. METHODS:Parturients requesting analgesia were randomly assigned to either patient-controlled intravenous remifentanil or epidural analgesia. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijoa.2015.06.003
更新日期:2015-11-01 00:00:00
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
doi:10.1016/j.ijoa.2016.03.005
更新日期:2016-08-01 00:00:00
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
doi:10.1016/j.ijoa.2007.01.014
更新日期:2007-07-01 00:00:00
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
doi:10.1016/j.ijoa.2004.04.007
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Ropivacaine may be the ideal spinal anesthetic for postpartum tubal ligation due to its medium duration of action, low incidence of side effects and possibly reduced post-anesthetic care unit (PACU) stay. METHODS:Two prospective up-down sequential allocation studies were performed using hyperbaric spinal ro...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2010.06.011
更新日期:2010-10-01 00:00:00
abstract::We describe the case of a 29-year-old parturient who, after undergoing elective cesarean delivery, displayed symptoms of lower extremity weakness and sensory deficit. Her past medical history was significant for asymptomatic Arnold Chiari Type I malformation and asthma. She had received spinal anesthesia that failed t...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2013.01.006
更新日期:2013-04-01 00:00:00