Nitrous Oxide Use for Pain in Labor, Conversion to Neuraxial Analgesia, and Birth Outcome.

Introduction: A variety of labor pain management options is essential to patients and their care providers. Inhaled, patient controlled nitrous oxide (NO) is a valuable addition to these options. The purpose of this study was to examine laboring patient, newborn, and provider characteristics associated with NO use for pain relief in labor and to examine the association between NO, conversion to neuraxial analgesia, and cesarean birth.

Anesthetic Management and Neuromonitoring in a Patient with Very Long-Chain Acyl-Coenzyme A Dehydrogenase Deficiency Undergoing Scoliosis Surgery: A Case Report and Review of Literature.

Patients with very long-chain acyl-CoA dehydrogenase deficiency (VLCADD) are prone to hypoglycemia and clinical decompensation when metabolic demands of the body are not met. We present a pediatric patient with VLCADD who underwent a posterior spinal fusion for scoliosis requiring intraoperative neurophysiology monitoring. Challenges included minimization of perioperative metabolic stressors and careful selection of anesthetic agents since propofol-based total intravenous anesthesia (TIVA) was contraindicated due to its high fatty acid content.

Concerns of Women Choosing Community Birth During the COVID-19 Pandemic: A Qualitative Study.

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, midwives have reported increased demand for community birth services. The purpose of this qualitative study was to understand childbearing persons' decision-making during the pandemic and to illuminate their experiences giving birth in community settings.

Methods: The study was framed by the interpretive phenomenological approach.

Malaria in Pregnancy: Considerations for Health Care Providers in Nonendemic Countries.

Malaria is a common infection world-wide, which carries significant risk of morbidity and mortality. Health care providers in the United States may lack experience in recognizing and treating this disease. The pathophysiology of malaria differs during pregnancy, resulting in increased risk for serious morbidity and mortality for the woman and her fetus.

A Public Health Ethics Analysis of the Criminalization of Direct Entry Midwifery.

Multiple types of midwives practice in the United States, but regulation of midwifery practice varies by state. In some states, direct entry midwifery practice is unregulated or criminalized. Because regulations are the most burdensome of the public health interventions, they require the most stringent ethical critique.