Concealed paracetamol overdose treated as HELLP syndrome in the presence of postpartum liver dysfunction.

Abstract:

:Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We report a case that was erroneously managed as HELLP syndrome before a paracetamol overdose was diagnosed. This case highlights current practice in managing paracetamol overdose and focuses on the importance of addressing mental health issues to mitigate the risk of self-harm in pregnancy.

journal_name

Int J Obstet Anesth

authors

Mills AT,Davidson ME,Young P

doi

10.1016/j.ijoa.2014.01.006

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

189-93

issue

2

eissn

0959-289X

issn

1532-3374

pii

S0959-289X(14)00028-4

journal_volume

23

pub_type

杂志文章
  • 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

    doi:10.1016/j.ijoa.2019.01.006

    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

  • 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

    doi:10.1016/j.ijoa.2013.05.009

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

    更新日期:2013-11-01 00:00:00

  • A randomised study of magnesium sulphate as an adjuvant to intrathecal bupivacaine in patients with mild preeclampsia undergoing caesarean section.

    abstract:BACKGROUND:Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. We therefore studied th...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2009.08.007

    authors: Malleeswaran S,Panda N,Mathew P,Bagga R

    更新日期:2010-04-01 00:00:00

  • A prospective study of post-cesarean delivery hypoxia after spinal anesthesia with intrathecal morphine 150μg.

    abstract:INTRODUCTION:Delayed respiratory depression is a feared complication of intrathecal morphine in patients undergoing cesarean delivery. The incidence, timing and risk factors for hypoxia in this population are not known. METHODS:Patients undergoing cesarean delivery under spinal anesthesia at a tertiary care center fro...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2017.06.003

    authors: Ladha KS,Kato R,Tsen LC,Bateman BT,Okutomi T

    更新日期:2017-11-01 00:00:00

  • Management of a parturient with paroxysmal nocturnal haemoglobinuria.

    abstract::We present the case of a 30-year-old parturient diagnosed in the first trimester of her first pregnancy as having paroxysmal nocturnal haemoglobinuria. Pancytopenia necessitated regular transfusion of blood products. The risks of infection, haemorrhage and thrombosis, in the presence of severe thrombocytopenia, mild n...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2004.02.003

    authors: Paech MJ,Pavy TJ

    更新日期:2004-07-01 00:00:00

  • Spinal anesthesia for cesarean section in a woman with Kartagener's syndrome and a twin pregnancy.

    abstract::Kartagener's syndrome is an inherited disease characterized by a triad of symptoms: bronchiectasis, situs inversus and sinusitis resulting from defective cilial motility. There are few reports in the literature regarding the optimum anesthetic technique in patients with Kartagener's syndrome. The main anesthetic consi...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2006.11.014

    authors: Gávai M,Hupuczi P,Berkes E,Beke A,Hruby E,Murber A,Urbancsek J,Papp Z

    更新日期:2007-07-01 00:00:00

  • Local infiltration of epinephrine-containing lidocaine with bicarbonate reduces superficial bleeding and pain during labor epidural catheter insertion: a randomized trial.

    abstract:BACKGROUND:Superficial bleeding after labor epidural catheter placement is a common phenomenon. In addition to delaying securing the epidural catheter, it may loosen the adhesive catheter dressing. The primary aim of this study was to determine whether skin infiltration with epinephrine-containing rather than plain lid...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2006.09.006

    authors: Carvalho B,Fuller A,Brummel C,Cohen SE

    更新日期:2007-04-01 00:00:00

  • Convulsions in a healthy parturient due to intrapartum water intoxication.

    abstract::Water intoxication during pregnancy is an uncommon event, usually associated with iatrogenic fluid overload, the prolonged administration of high doses of oxytocin or psychiatric disorder. This case report describes water intoxication presenting as the sudden onset of grand mal convulsions in the immediate postpartum ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(98)80032-0

    authors: Paech MJ

    更新日期:1998-01-01 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

    doi:10.1016/j.ijoa.2007.10.002

    authors: Cohen SE,Andes LC,Carvalho B

    更新日期:2008-01-01 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

    doi:10.1054/ijoa.2000.0818

    authors: Penney DJ,Smallman JM

    更新日期:2001-04-01 00:00:00

  • Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery.

    abstract::Combined spinal-epidural anesthesia balancing low-dose intrathecal bupivacaine/fentanyl and low-dose epidural bupivacaine may be more useful than single-shot spinal anesthesia for cesarean delivery in reducing incidences of adverse effects such as hypotension and nausea and in shortening motor recovery. Combined spina...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2005.05.009

    authors: Choi DH,Ahn HJ,Kim JA

    更新日期:2006-01-01 00:00:00

  • A sequential compression mechanical pump to prevent hypotension during elective cesarean section under spinal anesthesia.

    abstract:BACKGROUND:Spinal anesthesia is a standard technique for cesarean section but can cause hypotension which may be related to venous pooling secondary to progesterone-induced decreases in vascular tone. This study investigated the use of a sequential compression mechanical pump with thigh-high sleeves with compression cy...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2012.01.003

    authors: Sujata N,Arora D,Panigrahi BP,Hanjoora VM

    更新日期:2012-04-01 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

    doi:10.1016/j.ijoa.2018.09.006

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

    更新日期:2019-02-01 00:00:00

  • A randomized comparison of onset of anesthesia between spinal bupivacaine 5 mg with immediate epidural 2% lidocaine 5 mL and bupivacaine 10 mg for cesarean delivery.

    abstract:BACKGROUND:Previous studies using low-dose spinal anesthesia for cesarean delivery have focused on hypotension and efficacy. This study evaluated whether, using a combined spinal-epidural technique, there was a difference in onset of anesthesia for cesarean delivery between low-dose spinal with an immediate epidural lo...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2013.08.009

    authors: Wang LZ,Zhang YF,Hu XX,Chang XY

    更新日期:2014-02-01 00:00:00

  • Massive hemorrhage protocol activation in obstetrics: a 5-year quality performance review.

    abstract:BACKGROUND:A structured approach to hemorrhagic emergencies in obstetrics has gained popularity with the implementation of massive hemorrhage protocols. The trauma literature suggests that routine quality reviews should be in place to improve patient outcomes. The aim of this study was to develop quality indicators and...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2018.10.004

    authors: Margarido C,Ferns J,Chin V,Ribeiro T,Nascimento B,Barrett J,Herer E,Halpern S,Andrews L,Ballatyne G,Chapmam M,Gomes J,Callum J

    更新日期:2019-05-01 00:00:00

  • Personalized analgesic management for cesarean delivery.

    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

    authors: Carvalho B,Habib AS

    更新日期:2019-11-01 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

    doi:10.1016/j.ijoa.2009.08.004

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

    更新日期:2010-04-01 00:00:00

  • Retrospective study to investigate fresh frozen plasma and packed cell ratios when administered for women with postpartum hemorrhage, before and after introduction of a massive transfusion protocol.

    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

    authors: Weiniger CF,Yakirevich-Amir N,Sela HY,Gural A,Ioscovich A,Einav S

    更新日期:2018-11-01 00:00:00

  • Epidural analgesia in labour for a patient with hereditary neuropathy with liability to pressure palsy.

    abstract::Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare but probably under-diagnosed disorder of peripheral nerves in which individuals suffer from repeated motor and sensory neuropathies (pressure palsies) following brief nerve compression or mild trauma. A seemingly trivial insult such as sitting or ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1054/ijoa.2000.0828

    authors: Lepski GR,Alderson JD

    更新日期:2001-07-01 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

    doi:10.1016/j.ijoa.2010.10.002

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

    更新日期:2011-01-01 00:00:00

  • Anaesthesia for emergency caesarean section in a parturient with bleeding placenta praevia and a potentially malignant hyperthermia-susceptible fetus.

    abstract::A parturient who was 35 weeks' pregnant by her husband who was known to be susceptible to malignant hyperthermia, required anaesthesia for caesarean section for bleeding placenta praevia. The patient was considered to be haemodynamically stable and the procedure was carried out uneventfully under subarachnoid block. A...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1054/ijoa.2000.0394

    authors: Nanson JK,Sheikh A

    更新日期:2000-10-01 00:00:00

  • Maternal obesity and venous thromboembolism.

    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

    authors: Morgan ES,Wilson E,Watkins T,Gao F,Hunt BJ

    更新日期:2012-07-01 00:00:00

  • "The future of the midwife depends on her power to relieve pain". The rise and fall of the Analgesia in Childbirth Bill (1949).

    abstract::The Analgesia in Childbirth Bill (1949) remains the only attempt in British history to give mothers the legal right to pain relief in childbirth. It provides a useful introduction to the major themes in the history of British obstetric anaesthesia and analgesia under the National Health Service. This paper places the ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 历史文章,杂志文章

    doi:10.1016/j.ijoa.2006.08.007

    authors: Barnett R

    更新日期:2007-01-01 00:00:00

  • Effect of fluid preload on maternal haemodynamics for low-dose epidural analgesia in labour.

    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

    authors: Hawthorne L,Slaymaker A,Bamber J,Dresner M

    更新日期:2001-10-01 00:00:00

  • Arterial aneurysms of the lienorenal axis during pregnancy.

    abstract::Rupture of an aneurysm of the renal or splenic arteries remains a rare but catastrophic complication of pregnancy with a generally dismal prognosis for both mother and fetus. Improvements in abdominal imaging for incidental conditions are unlikely to lead to earlier diagnosis of such abnormalities antenatally, hence c...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/S0959-289X(02)00187-5

    authors: Popham P,Buettner A

    更新日期:2003-04-01 00:00:00

  • Comparison of three different loading doses to establish epidural analgesia in labour.

    abstract::Women requesting epidural analgesia were randomized to receive one of three loading doses. Group 1 received a single dose of bupivacaine 9.375 mg (15 ml of 0.0625%) containing fentanyl 37.5 microg and adrenaline 37.5 microg group 2 received a single dose of bupivacaine 15 mg (15 ml of 0.1%) containing fentanyl 30 micr...

    journal_title:International journal of obstetric anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0959-289x(98)80005-8

    authors: Scrutton MJ,Porter JS,O'Sullivan G

    更新日期:1998-07-01 00:00:00

  • Potency and sterility of anesthetic drugs in obstetric anesthesia.

    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

    authors: Wagner DS,Naughton NN,Pierson C,Michel T

    更新日期:2002-10-01 00:00:00

  • Extending epidural blockade for emergency caesarean section. Evaluation of 2% lignocaine with adrenaline.

    abstract::Pre-existing epidural analgesia was rapidly extended in 36 consecutive patients presenting for emergency caesarean section by using 20 ml of 2% lignocaine + 1/200,000 adrenaline freshly prepared given by slow bolus injection. Despite a wide range of initial analgesic sensory levels the technique produced blocks that w...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/0959-289x(91)90024-k

    authors: Price ML,Reynolds F,Morgan BM

    更新日期:1991-09-01 00:00:00

  • Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry.

    abstract:BACKGROUND:In South Africa, hypertensive disorders of pregnancy are the leading cause of maternal mortality. More than 50% of anaesthesia-related maternal deaths are attributed to complications of airway management. We compared the prevalence and risk factors for hypoxaemia during induction of general anaesthesia in pa...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2020.10.012

    authors: Smit MI,du Toit L,Dyer RA,van Dyk D,Reed AR,Lombard CJ,Hofmeyr R

    更新日期:2020-11-04 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

    doi:10.1016/S0959-289X(02)00198-X

    authors: Boyle RK

    更新日期:2003-07-01 00:00:00