Post Partum Death in a Patient Diagnosed With COVID-19.

There are few case reports describing maternal mortality and intensive care of the pregnant patient with COVID-19 infection. A 27-year-old patient at 34 weeks of gestation was admitted for the evaluation of cough, fever, tachypnea, and oligohydramnios. The day of admission she underwent cesarean delivery for a non-reassuring fetal heart rate tracing.

Spinal Cord Trauma During Subarachnoid Anesthesia for Cesarean Delivery: A Case Report.

Spinal cord trauma can occur during subarachnoid blockade and can result in significant morbidity for the patient. Careful attention to lumbar insertion level is essential to prevent injury.

A qualitative analysis of parturients' experiences using nitrous oxide for labor analgesia: It is not just about pain relief.

Background: A vast majority of women who choose nitrous oxide for labor report high satisfaction despite variable analgesic effectiveness. We analyzed comments provided by women who used nitrous oxide for labor, to identify determinants of satisfaction in this population, and to better understand reasons for continuing with nitrous oxide despite variable analgesic effectiveness.

Methods: We conducted qualitative content analysis of comments in a quality improvement database of routine follow-up assessments of women who delivered vaginally, using nitrous oxide as the sole labor analgesic.

A Survey of Enhanced Recovery After Surgery Protocols for Cesarean Delivery in Serbia.

Enhanced recovery after surgery (ERAS) protocols have been described for patients undergoing colon surgery. Similar protocols for cesarean delivery (CD) have been developed recently. CD is one of the most commonly performed surgical procedures, and adoption of ERAS protocols following CD might benefit patients and the health-care system.

Recent advances of simulation in obstetric anesthesia.

Purpose Of Review: Simulation training in obstetric anesthesia has become widespread in recent years. Simulations are used to train staff and trainees, assess and improve team performance, and evaluate the work environment. This review summarizes current research in these categories.

Continuous Spinal Anesthesia for Obstetric Anesthesia and Analgesia.

The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery.

Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration.

Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc.

Should Nitrous Oxide Be Used for Laboring Patients?

Nitrous oxide, long used during labor in Europe, is gaining popularity in the United States. It offers many beneficial attributes, with few drawbacks. Cost, safety, and side effect profiles are favorable.

Nitrous Oxide During Labor: Maternal Satisfaction Does Not Depend Exclusively on Analgesic Effectiveness.

Background: Evidence on the analgesic effectiveness of nitrous oxide for labor pain is limited. Even fewer studies have looked at patient satisfaction. Although nitrous oxide appears less effective than neuraxial analgesia, it is unclear whether labor analgesic effectiveness is the most important factor in patient satisfaction.

The Effects of Vasopressin and Oxytocin on the Fetoplacental Distal Stem Arteriolar Vascular Resistance of the Dual-Perfused, Single, Isolated, Human Placental Cotyledon.

Background: Vasoactive agents administered to counter maternal hypotension at cesarean delivery may theoretically intensify the hypoxemic fetoplacental vasoconstrictor response and, hence, negatively impact transplacental oxygen delivery to the fetus. Yet, this aspect of their pharmacodynamic profiles is seldom mentioned, let alone investigated. We hypothesized that vasopressin, a potent systemic vasoconstrictor, and oxytocin, a uterotonic agent administered routinely at cesarean delivery, which, in contrast to vasopressin, possesses significant systemic vasodilator properties, would not influence distal stem villous arteriolar resistance.

Review: Potential druggable targets for the treatment of early onset preeclampsia.

Placental delivery is the only known cure for early onset preeclampsia, a major cause of maternal and neonatal morbidity and mortality worldwide. Prolonging pregnancy beyond 25weeks without undue maternal risk favors fetal survival, improves neonatal outcome and saves money. In vitro experiments using human placental tissue and in vivo studies employing "preeclamptic" animal models reveal the presence of likely druggable targets, especially within the maladapted intracellular nucleotide transduction pathways of preeclampsia.

Maintaining perioperative normothermia in the patient undergoing cesarean delivery.

Anesthesia and surgery interfere with normal thermoregulation, and nearly all patients will become hypothermic unless compensatory measures are used. Preoperative patient warming and intraoperative methods using forced air and warmed intravenous fluids are important methods for maintaining patient's core temperature during the perioperative period. The benefits of maintaining normothermia include reductions in postoperative wound infection, the risk of perioperative coagulopathy, and myocardial ischemia.

Nitrous oxide for labor analgesia: expanding analgesic options for women in the United States.

Nitrous oxide (N2O) is a commonly used labor analgesic in many Western countries, but is used infrequently in the United States. The University of California at San Francisco has been offering N2O for labor analgesia for more than 30 years. Vanderbilt University Medical Center recently began offering N2O as an option for pain relief in laboring women.

The management of accidental dural puncture and postdural puncture headache: a North American survey.

Study Objective: To evaluate the management of accidental dural puncture (ADP) and postdural puncture headache (PDPH) among obstetric anesthesiologists practicing in North America.

Design: Questionnaire survey of individual members of the Society for Obstetric Anesthesia and Perinatology (SOAP).

Setting: University hospital.

Imaging during pregnancy.

The use of imaging techniques in women who are pregnant has increased greatly over the past decade. This focused review discusses the risks and indications of ultrasonography, magnetic resonance imaging, computed tomographic scanning, and fluoroscopy for the evaluation of the parturient with non-obstetric disorders. Diagnostic imaging of the pregnant woman for the evaluation of disorders not related to pregnancy is evolving, and protocols will vary from institution to institution.

Intracranial venous thrombosis in the parturient.

Intracranial venous thrombosis is a rare but potentially fatal complication of pregnancy and the postpartum period. The presenting symptoms can mimic those of a postdural puncture headache and are easily misdiagnosed, especially in a parturient who has undergone regional anesthesia. The incidence of 10-20 per 100,000 is likely higher than reported.