Right atrial and ventricular clot as a cause of peri-arrest during caesarean birth requiring immediate thrombectomy.

Venous thromboembolic disease remains a leading cause of maternal morbidity and mortality. We report a case of a 30-year-old woman at 37 gestation with a history of thalassaemia intermedia and splenectomy. During pregnancy, she had been managed with frequent blood transfusions and enoxaparin.

Novel bimanual haptic simulator for epidural loss-of-resistance detection: a pilot study assessing movement strategies and performance across anesthesiologist experience levels.

Background: Correct identification of the epidural space requires extensive training for technical proficiency. This study explores a novel bimanual haptic simulator designed for the precise insertion of an epidural needle based on loss-of-resistance (LOR) detection, providing realistic dual-hand force feedback.

Methods: The simulator, equipped with two haptic devices connected to a Tuohy needle and an LOR syringe, was designed to simulate the tissues' resistive forces felt by the user during the procedure, offer anatomical variability and record detailed performance metrics for personalized feedback.

ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.

Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.

Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.

Complement-mediated hemolytic uremic syndrome associated with postpartum hemorrhage: case series and systematic review of individual participant data.

Background: Postpartum hemorrhage is considered a risk factor for pregnancy-associated complement-mediated hemolytic uremic syndrome (CM-HUS; previously known as atypical hemolytic uremic syndrome) but has not been systematically studied.

Objectives: To systematically examine the role of postpartum hemorrhage in precipitating CM-HUS and to describe the characteristics of postpartum hemorrhage-associated CM-HUS, its prognosis and recommended management.

Methods: A systematic review of individual participant data from case series and reports in addition to a case series from our institution.

Patient/anesthesiologist intersubjective experiences and intravenous supplementation during elective cesarean delivery: A prospective patient-reported outcome study.

Introduction: This prospective, observational study investigated the impact of patient/anesthesiologist interactions and socioeconomic factors on administering intravenous analgesics and anxiolytics during elective Cesarean delivery under spinal anesthesia. The study explored the role of emotional experiences and psychosocial characteristics on intraoperative administration of intravenous adjuncts.

Methods: The study included 502 patient/anesthesiologist dyads from two hospitals in Israel.

Anesthetic management for fetal surgery: Lessons from a single-center experience (2019-2023).

Fetal surgery presents distinctive anesthetic challenges due to the need to balance maternal and fetal safety. This retrospective study evaluates the anesthetic management strategies used at a single center for various fetal interventions, including fetoscopic laser photocoagulation, fetal endoluminal tracheal occlusion, bipolar cord coagulation, and fetoscopic spina bifida repair. We reviewed 195 fetal procedures performed between 2019 and 2023 at Rabin Medical Center.

Peripartum anesthesia management and outcomes of patients with congenital heart disease: a single-center retrospective analysis (2009-2023).

Background: Advances in medicine have enabled more patients with congenital heart disease (CHD) to become pregnant. However, these patients face significant challenges during the peripartum period. Current peripartum anesthesia guidelines for CHD patients mainly rely on case reports and small series.

Conversion to general anesthesia and intravenous supplementation during intrapartum cesarean delivery with an indwelling epidural catheter: a retrospective study.

Background: Intraoperative pain during cesarean delivery with or without conversion to general anesthesia has been shown to negatively impact maternal and perinatal morbidity. Efforts to reduce these adverse events are a recent focus of obstetric anesthesia care. We aimed to assess rates of and risk factors for conversion to general anesthesia and intraoperative pain during intrapartum cesarean delivery with an indwelling epidural catheter in our academic center.

The Effect of Prolonged Face Mask Ventilation on Gastric Insufflation: A Prospective Observational Study.

Background: Pulmonary aspiration is a potentially lethal perioperative complication that can be precipitated by gastric insufflation. Face mask ventilation (FMV), a ubiquitous anesthetic procedure, can cause gastric insufflation. FMV with an inspiratory pressure of 15 cm H2O provides the best balance between adequate pulmonary ventilation and a low probability of gastric insufflation.

Incidence and clinical impact of aspiration during cesarean delivery: A multi-center retrospective study.

Background: The risk of aspiration during general anesthesia for cesarean delivery has long been thought to be increased due to factors such as increased intra-abdominal pressures and delayed gastric emptying in pregnant patients. However, recent studies have reported normal gastric emptying in pregnant patients, suggesting that the risk of aspiration may not be as high as previously believed.

Methods: We conducted a retrospective study of 48,609 cesarean deliveries, of which 22,690 (46.

The relationship between postpartum pain and mother-infant bonding: A prospective observational study.

Introduction: Postpartum pain is associated with impaired maternal recovery and may influence mother-infant bonding.

Methods: Participants who underwent a vaginal or cesarean delivery were assessed 24 h postpartum. Postpartum pain intensity was measured using the Verbal Numeric Score (VNS) (0-10) and classified as non-severe (<8) or severe pain (≥8).

Fetal surgery using fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: a single-center experience.

Purpose: To provide a comprehensive report of the experience gained in the prenatal treatment of congenital diaphragmatic hernia (CDH) using fetoscopic endoluminal tracheal occlusion (FETO) following its implementation at a newly established specialized fetal medicine center.

Methods: Mothers of fetuses with severe CDH were offered prenatal treatment by FETO.

Results: Between 2018 and 2021, 16 cases of severe CDH underwent FETO.

Association of inpatient postpartum quality of recovery with postpartum depression: A prospective observational study.

Study Objective: To explore the relationship between Obstetric Quality of Recovery survey (ObsQoR-10-Heb) and Edinburgh postnatal depression scale (EPDS) measured 6 weeks after delivery, adjusted for potential confounding factors.

Design: Prospective, longitudinal cohort study.

Setting: Large postpartum department, 13,000 annual deliveries, quaternary medical center in Israel.

Prophylactic Administration of Tranexamic Acid Reduces Blood Products' Transfusion and Intensive Care Admission in Women Undergoing High-Risk Cesarean Sections.

Postpartum hemorrhage (PPH) remains a major cause of maternal mortality. Tranexamic acid (TxA) has shown effectiveness in reducing PPH-related maternal bleeding events and deaths. We conducted a cohort study including parturient women at high risk of bleeding after undergoing a cesarean section (CS).

The effect of placement and management of intrathecal catheters following accidental dural puncture on the incidence of postdural puncture headache and severity: a retrospective real-world study.

Accidental dural puncture during an attempt to establish labour epidural analgesia can result in postdural puncture headache and long-term debilitating conditions. Epidural blood patch, the gold standard treatment for this headache, is invasive and not always successful. Inserting an intrathecal catheter after accidental dural puncture may prevent postdural puncture headache.

Medical and obstetric comorbidities and delivery outcomes in overweight and obese parturients: a retrospective analysis.

Background: Research on obesity in women of reproductive age is heterogeneous in gestational age and body mass index (BMI) classification and focused mostly on pregnancy-related rather than medical comorbidities. We studied the prevalences of pre-pregnancy BMI, chronic maternal and obstetric comorbidities, and delivery outcomes.

Methods: Retrospective analysis of real-time data collected during deliveries in a single tertiary medical center.

An explorative analysis of pharmacovigilance data of oxytocin and its analogue carbetocin, with a focus on haemodynamic adverse effects.

Background: Oxytocin and its analogue carbetocin are uterotonics whose prophylactic use is recommended to prevent postpartum haemorrhage, which is one of the leading causes of maternal deaths worldwide. However, both drugs can cause specific adverse effects and haemodynamic challenges.

Aim: The aim of this work was to exploratively examine reports of adverse drug events of both drugs and to establish a comparative haemodynamic profile.

Obstetric anaesthesia manpower and service provision issues (introduction and European perspective).

Global health is an important and far-reaching concept in which health and access to surgical and anaesthetic care is crucial. Universal access to anaesthesia is a challenge in many countries. Manpower shortages are an important cause of difficulties and each European country has found different ways of facing a lack of healthcare professionals.

The effect of preoperative anxiety and ovarian stimulation on gastric antrum size: a prospective observational study.

Pulmonary aspiration is a potentially lethal perioperative complication related to gastric size and contents. Several perioperative factors are believed to increase gastric size, while others are less studied. This prospective observational study aimed to investigate the effect of preoperative anxiety and hormone-induced ovarian stimulation on gastric size examined by gastric ultrasound.

Incidence of conversion to general anaesthesia and need for intravenous supplementation in parturients undergoing caesarean section under spinal anaesthesia: A retrospective observational study.

Background: Conversion from spinal anaesthesia to general anaesthesia (GA) was shown to be associated with more complications. It has been postulated that spinal injection of a low dose of local anaesthetic is a risk factor. We aimed to discover the rate of conversion from spinal anaesthesia to GA in women who received at least 10 mg heavy bupivacaine and opioids and assess its risk factors.

Optimal uterotonic management.

Uterotonics play an important role in the management of postpartum haemorrhage (PPH), often caused by uterine atony. The World Health Organization (WHO) recommends the application of uterotonics for all births. Oxytocin, considered the first-line uterotonic, binds to a G protein-coupled receptor which is subject to down sensitization upon repeated or prolonged administration of oxytocin.

The Impact of a 22-Month Multistep Implementation Program on Speaking-Up Behavior in an Academic Anesthesia Department.

Background: Speaking-up is a method of assertive communication that increases patient safety but often encounters barriers. Numerous studies describe programs introducing speaking-up with varying success; the common denominator seems to be the need for a multimodal and sustained approach to achieve the required change in behavior and culture for safer health care.

Methods: Before implementing a 22-month multistep program for establishing and strengthening speaking-up at our institution, we assessed perceived safety culture using the "Safety Attitudes Questionnaire.