Anesthetic Management of a Laboring Patient With a Closed-Loop Stimulation Pacemaker: A Case Report.

A new generation of cardiac implantable devices, known as Closed Loop Stimulation pacemakers, are now utilized to reduce episodes of bradycardia, syncope, and tachycardia in pregnant women. The device functions differently than conventional pacemakers by responding to changes in the patient`s cardiac output and heart rate based on physiologic demands and acute mental stress. Increased metabolic demands, including physiologic stress often accompany pregnancy, labor, and delivery.

Maternal and Fetal Outcomes With Early Neuraxial Engagement in Obese Parturients.

Research indicates the combination of obesity and pregnancy is correlated with increased morbidity, mortality, and healthcare costs. The clinical inquiry of this study was: Does early neuraxial placement in obese parturients decrease the rate of cesarean delivery, decrease use of general anesthesia, and improve fetal Apgar scores? A retrospective analysis of 212 obese parturients with neuraxial anesthesia based on cervical dilation at time of placement and low-intervention delivery was conducted to evaluate the impact of early neuraxial intervention. The study site was a university-affiliated women and children's hospital in the US Midwest.