Headache is what we commonly think of as a sequela of dural puncture. Other adverse consequences of dural puncture include ocular and auditory disturbance. Ocular abnormalities are due to cranial nerve palsy, typically involving the sixth nerve cranial (abducens nerve), and uncommonly involving the third and fourth cranial nerves. Dr. Jennifer E. Hofer, Department of […]
A recent aa2day summary described a case of a pregnant patient who suffered a cardiac arrest. The authors noted that the patient had a hyperdynamic left ventricle with concentric remodeling, signs of heart failure. It’s important that anesthesiologists caring for parturients understand the physiology and clinical presentation of heart disease, as well as the management […]
Oxytocin is routinely administered during the third stage of labor for prophylaxis against postpartum hemorrhage, a leading cause of morbidity and mortality. If the uterus does not adequately contract in response to oxytocin administration, other drugs can be used. Second-line uterotonics include methylergonovine maleate, carboprost, and misoprostol. Which drugs are actually used? Dr. Brian T. […]
Is there an association between ethnicity and maternal death? A study in a southern tertiary care hospital
Despite advances in maternal care, approximately 1 in 5000 women die in childbirth in the United States each year. African-American women are nearly 4 times more likely to die in childbirth than Caucasian women. Dr. Michael Froelich, Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, Alabama, and colleagues noted that at the University of […]
Can labor pain, need for local analgesics during labor, and time to epidural analgesia request for labor be predicted?
Labor is the process of childbirth, from the start of uterine contractions to the delivery of the fetus and placenta. Labor hurts, of course, and the intensity of labor pain increases over the course of labor. Nevertheless, women experience pain differently. Can we understand this variability? Dr. Brendan Carvalho, Department of Anesthesia, Stanford University School […]
Postpartum depression is triggered by childbirth and possibly additionally by the intensity of pain experienced during childbirth. If epidural anesthesia is used, is the incidence of postoperative depression affected? Dr. Dong-Xin Wang, Department of Anesthesiology and Surgical Intensive Care, Peking University First Hospital, Beijing, China, and colleagues report on a cohort of 214 nulliparous women […]