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 the current pregnancy, between 2001 and 2016. Pregnancy outcomes of these women were firstly compared with all contemporary non-exposed patients (n=35 411), and secondly with 684 non-exposed control patients, matched for age, time of delivery and parity. RESULTS:The incidence of non-obstetric surgery during pregnancy was 0.48%, mostly performed during the second trimester (44%) and under general anesthesia (81%). Intra-abdominal surgery (44%) was the most commonly performed procedure, predominantly using laparoscopy (79%). Women undergoing surgery delivered earlier and more frequently preterm (25% vs. 17%, P=0.018); and birth weight was significantly lower [median (95% CI) 3.16 (3.06 to 3.26) vs. 3.27 (3.22 to 3.32) kg, P=0.044]. When surgery was performed under general anesthesia, low birth weight was more frequent (22% vs 6%, P=0.046). Overall pregnancy outcomes were neither influenced by trimester nor location (intra- vs extra-abdominal) of surgery. However, preterm birth rate secondary to surgery was higher for interventions during the third trimester, compared with other trimesters (10% vs 0, P <0.001). CONCLUSION:Pregnant women who underwent surgery delivered preterm more frequently and their babies had lower birth weights. Laparoscopic surgery did not increase the incidence of adverse pregnancy outcomes. General anesthesia was associated with low birth weight. Whether these associations suggest causation or reflect the severity of the underlying condition remains speculative.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Devroe S,Bleeser T,Van de Velde M,Verbrugge L,De Buck F,Deprest J,Devlieger R,Rex Sdoi
10.1016/j.ijoa.2019.01.006subject
Has Abstractpub_date
2019-08-01 00:00:00pages
74-81eissn
0959-289Xissn
1532-3374pii
S0959-289X(18)30376-5journal_volume
39pub_type
杂志文章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:The aim of this study was to describe the current obstetric anaesthetic practices in Austria by performing a comprehensive questionnaire survey. METHODS:A questionnaire was sent via email to key anaesthesiologists from obstetric anaesthesia departments of 81 hospitals registered at the Austrian Ministry of ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2019.02.002
更新日期:2019-08-01 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::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
doi:10.1016/j.ijoa.2006.12.004
更新日期:2007-10-01 00:00:00
abstract::We review the evidence base for fluid management in pre-eclampsia. Current understanding of the relevant pathophysiology and the possible impact of styles of fluid management on maternal and fetal outcome are presented. There is little evidence upon which to base the management of fluid balance in pre-eclampsia. Repor...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/s0959-289x(99)80106-x
更新日期:1999-10-01 00:00:00
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
更新日期:2020-11-04 00:00:00
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
doi:10.1016/j.ijoa.2007.07.006
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Epidural labor analgesia inclusive of high-dose fentanyl has been thought to affect breastfeeding in multiparous patients. In our experience, this effect is not as significant as quoted in the literature. This study was designed to evaluate breastfeeding success in women receiving epidural analgesia with fen...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2010.02.001
更新日期:2010-07-01 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: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
更新日期:2017-11-01 00:00:00
abstract::Recent work suggests that preoperative skin infiltration with local anesthetic may lead to reduced postoperative pain. We have studied this in a randomised, prospective, double-blind trial of 40 women having cesarean section under spinal anesthesia. After establishment of the spinal block, the incision line was infilt...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(94)90068-x
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:A head-elevation pillow places a patient in a ramped posture, which maximises the view of the larynx during laryngoscopy, particularly in obese parturients. In our institution an elevation pillow is used pre-emptively for neuraxial anaesthesia. We hypothesised that head-elevation may impair cephalad spread o...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijoa.2015.08.004
更新日期:2015-11-01 00:00:00
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 repo...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2014.01.006
更新日期:2014-05-01 00:00:00
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
更新日期:2010-04-01 00:00:00
abstract::Blood pressure monitoring is a critical component of antenatal, peripartum and postnatal care. The accurate detection and treatment of abnormal blood pressure during pregnancy is essential for the optimisation of maternal and neonatal outcomes. Increasing maternal obesity in western populations is well documented. The...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2018.04.004
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:A national survey of current practice and preferred drug choices for both induction and maintenance of general anaesthesia for caesarean section was undertaken. METHODS:Following approval by the Obstetric Anaesthetists' Association, all UK consultant members were invited to respond to an electronic survey. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2012.09.001
更新日期:2013-01-01 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::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
更新日期:1998-01-01 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::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::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
更新日期:2003-07-01 00:00:00
abstract::This study explores which concentrations of local anesthetics might be expected to inhibit the growth of Staphylococcus aureus. Serial dilutions were made of 0.5% and 0.75% bupivacaine, 2% and 5% lidocaine, 2% and 3% chloroprocaine, and 0.2% and 1% ropivacaine. To each concentration of local anesthetic solution, Muell...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1054/ijoa.2001.0934
更新日期:2002-04-01 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::The aim of the 2012 "What's new in obstetric anesthesia?" review is to highlight important scientific and medical advances in the fields of obstetric anesthesiology, obstetrics and perinatology from literature published in 2011. This review will consider advances in the prevention and treatment of important obstetric ...
journal_title:International journal of obstetric anesthesia
pub_type:
doi:10.1016/j.ijoa.2012.08.005
更新日期:2012-10-01 00:00:00
abstract::Neurofibromatosis type 2 is an extremely rare form of neurofibromatosis characterized by central nervous system involvement with bilateral vestibular schwannomas and spinal tumors. Anesthetic management of a parturient with neurofibromatosis type 2 has not been fully reported, and the condition is challenging to obste...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2005.02.007
更新日期:2005-10-01 00:00:00
abstract::Magnesium is one of the most abundant cations in the human body. It is utilised extensively within the medical world and its role in the treatment of various conditions in both mother and fetus is increasing. This review focuses on the importance of magnesium for the obstetric anaesthetist and looks at the most recent...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2012.10.003
更新日期:2013-01-01 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:BACKGROUND:There are limited data about spinal dosing for cesarean delivery in preterm parturients. We investigated the hypothesis that preterm gestation is associated with an increased incidence of inadequate spinal anesthesia for cesarean delivery compared with term gestation. METHODS:We searched our perioperative d...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2016.01.007
更新日期:2016-05-01 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::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