A 25-yr-old obese parturient with mild asthma underwent an uneventful spinal anesthetic for primary cesarean delivery. Within 4 h after delivery, the patient twice developed acute shortness of breath, inspiratory stridor, and hypoxemia that required intubation. A battery of blood tests revealed no evidence of an allergic reaction. She had a normal echocardiogram and chest computed tomography, but her neck computed tomography showed an enlarged left thyroid lobe asymmetrically compressing the endotracheal tube cuff. We hypothesized that, after delivery, decreased maternal vascular capacitance increased central venous pressure such that venous engorgement of an undiagnosed goiter may have caused symptomatic tracheal compression.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1213/ane.0b013e3181979e01 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association of obesity with ropivacaine and sufentanil EC50 in labor analgesia: a single-center prospective study.
Eur J Clin Pharmacol
January 2025
Department of Anesthesiology, the Second Afffliated Hospital of Soochow University, Suzhou City, People's Republic of China.
Objective: In part I, measure the EC50 of sufentanil in obese and non-obese parturients combined with 0.1% ropivacaine and compare the differences. Similarly, in part II, measure the EC50 of ropivacaine in obese and non-obese parturients combined with 0.
View Article and Find Full Text PDFMorbid obesity: Optimizing neuraxial analgesia and cesarean delivery outcomes.
Best Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.
View Article and Find Full Text PDFOxytocin versus carbetocin at elective Cesarean delivery in parturients with class III obesity: a double-blind randomized controlled noninferiority trial.
Can J Anaesth
January 2025
Department of Anesthesia and Pain Management, Mount Sinai Hospital, Mount Sinai Toronto, ON, Canada.
Purpose: Class III obesity (body mass index [BMI] ≥ 40 kg·m) is associated with high rates of Cesarean deliveries and postpartum hemorrhage, with increased maternal and fetal morbidity. The doses of oxytocin and carbetocin are two to four times higher at Cesarean delivery in patients with class III obesity. We sought to investigate the efficacy of carbetocin 80 µg iv compared with oxytocin 1 IU iv (plus infusion) at elective Cesarean delivery in parturients with class III obesity.
View Article and Find Full Text PDFAdvances in Epidural Labor Analgesia for Obese Parturients.
J Pain Res
December 2024
Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, People's Republic of China.
With the development of society and economy, and the improvement of people's living standards, obesity has gradually become a significant issue not only in China but globally. Epidural anesthesia, being the most commonly used method for labor analgesia in clinical practice, has significantly reduced the pain experienced by parturients during childbirth and decreased the cesarean delivery rate. However, due to the anatomical and physiological differences between obese and non-obese parturients, the effectiveness and techniques of labor analgesia may vary.
View Article and Find Full Text PDFFlat Oral Glucose Tolerance Test during Pregnancy and Risk for Type 2 Diabetes: A 5-Year Cohort Study.
Am J Perinatol
December 2024
Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel.
Objective: This study aimed to evaluate the risk of type 2 diabetes mellitus (T2DM) in women with flat response in the 100-g oral glucose tolerance test (OGTT) performed during pregnancy in a large cohort of women with up to 5 years of follow-up.
Study Design: A retrospective analysis of women with documented OGTT during pregnancy and T2DM data up to 5 years after pregnancy. Gestational diabetes mellitus (GDM) screening was done by a two-step strategy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!