Effect of Intrathecal Bupivacaine Dose on the Success of External Cephalic Version for Breech Presentation: A Prospective, Randomized, Blinded Clinical Trial.

Background: Breech presentation is a leading cause of cesarean delivery. The use of neuraxial anesthesia increases the success rate of external cephalic version procedures for breech presentation and reduces cesarean delivery rates for fetal malpresentation. Meta-analysis suggests that higher-dose neuraxial techniques increase external cephalic version success to a greater extent than lower-dose techniques, but no randomized study has evaluated the dose-response effect.

Correlation of probability scores of placenta accreta on magnetic resonance imaging with hemorrhagic morbidity.

Study Objective And Design: To evaluate the hypothesis that assigning grades to magnetic resonance imaging (MRI) findings of suspected placenta accreta will correlate with hemorrhagic outcomes. We chose a single-center, retrospective, observational design.

Setting, Patients, And Measurements: Nulliparous or multiparous women who had antenatal placental MRI performed at a tertiary level academic hospital were included.

How to Manage Allergic Reactions to Contrast Agent in Pregnant Patients.

Objective: This article reviews optimal treatment of allergic reactions to iodinated contrast material in pregnant patients. Initial evaluation and treatment of a pregnant patient is similar to that for a nonpregnant patient. However, additional steps, including assessment for uterine cramping, using left uterine displacement to improve venous return, and maintaining blood pressure to ensure placental perfusion, may be required.

Anesthetic management of external cephalic version.

Breech presentation is common at term and its reduction through external cephalic version represents a noninvasive opportunity to avoid cesarean delivery and the associated maternal morbidity. In addition to uterine relaxants, neuraxial anesthesia is associated with increased success of version procedures when surgical anesthetic dosing is used. The intervention is likely cost effective given the effect size and the avoided high costs of cesarean delivery.

Naturally occurring Tyzzer's disease in cotton-top tamarins (Saguinus oedipus).

We noted naturally occurring infection with Clostridium piliforme (Tyzzer's disease) in 2 captive-reared cotton-top tamarins (Saguinus oedipus). Spontaneous Tyzzer's disease has been reported in multiple species of laboratory, domestic, and wild animals but is extremely rare in humans and nonhuman primates. Distinct from idiopathic colitis, which is common in cotton-top tamarins, these 2 tamarins had severe, transmural, necrotizing typhlocolitis accompanied by myocarditis and hepatitis.