Obstetrics

2020 ◽  
pp. 155-187
Author(s):  
Mark Scrutton ◽  
Michael Kinsella
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Emergency Management ◽  
Management Strategies ◽  
Placenta Praevia ◽  
Online Resources ◽  
Failed Intubation ◽  
Severe Haemorrhage ◽  
Accidental Dural Puncture ◽  
Cord Prolapse

This chapter covers emergency management for obstetric crises including maternal collapse, severe haemorrhage, amniotic fluid embolus, pre-eclampsia and eclampsia, total spinal, accidental dural puncture, cord prolapse, failed intubation, ruptured ectopic, retained placenta, and placenta praevia. The authors give guidance on how to perform intrauterine resuscitation and conduct anaesthesia for a category I Caesarean section. In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential obstetric-related situation are given. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

Obstetrics

2009 ◽  
pp. 145-178 ◽  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Dural Puncture ◽  
Placenta Praevia ◽  
Failed Intubation ◽  
Retained Placenta ◽  
Severe Haemorrhage ◽  
Amniotic Fluid Embolus ◽  
Accidental Dural Puncture

Maternal collapse 146 Intrauterine fetal resuscitation 150 Severe haemorrhage 152 Amniotic fluid embolus 155 Severe pre-eclampsia 156 Eclampsia 159 Total spinal 160 Accidental dural puncture 162 Category 1 Caesarean section 164 Problems during Caesarean section 168 Failed intubation—obstetrics 170 Placenta praevia 174 Retained placenta 176...

scholarly journals A study on correlation of placenta praevia with previous caesarean section and other risk factors

2019 ◽  
Vol 7 (6) ◽  
pp. 2027
Author(s):  
Somika Kaul ◽  
Shahida Mir
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Placenta Praevia ◽  
Previous Caesarean Section ◽  
Jammu And Kashmir ◽  
Dilatation And Curettage ◽  
Obstetric Haemorrhage ◽  
Increased Risk ◽  
History Of

Background: Obstetric haemorrhage is the leading cause of preventable maternal mortality worldwide. One of the major contributors to obstetric haemorrhage is antepartum haemorrhage which is mainly caused by placenta praevia and abruptio placenta. The study aims to quantify the risk of placenta praevia based on the presence and number of caesarean sections and to assess other risk factors.Methods: This study was a prospective case control study conducted in the department of obstetrics and gynecology, Lalla Ded hospital, Srinagar, Jammu and Kashmir, India from August 2009 to October 2010. As per the inclusion and exclusion criteria of study 100 cases and 200 controls were selected and the association of placenta praevia with proposed risk factors was analysed statistically.Results: Present study showed that the risk of developing placenta praevia in future pregnancy increased steadily as the number of previous caesarean sections increased, risk being 2.1, 2.8 and 4 times with previous one, two and three caesarean deliveries respectively. Similarly, the risk of developing placenta praevia was more in women with history of previous abortion (risk being 2.8 and 6.5 times more in women with one and two abortions in the past). Previous dilatation and curettage and age more than 30 years also proved to be independent risk factors.Conclusions: To conclude advanced maternal age, previous abortion, dilatation and curettage and a history of previous caesarean section appear to increase the occurrence of placenta praevia. The study strongly emphasises the need to decrease the primary caesarean section rate.

Recovery problems

2020 ◽  
pp. 331-368
Author(s):  
Charles Gibson
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndromes ◽  
Management Strategies ◽  
Postoperative Nausea And Vomiting ◽  
Online Resources ◽  
Residual Neuromuscular Blockade ◽  
Consciousness Level ◽  
Coronary Syndromes ◽  
Acute Confusion ◽  
Clinical Problems

This chapter details the clinical problems anaesthetists often face with patients in the recovery unit. These include acute coronary syndromes and other causes of chest pain, acute heart failure, hypertension and hypotension, respiratory failure and hypoxia, acute confusion, lowered consciousness level and stroke, residual neuromuscular blockade, oliguria and acute renal failure, severe postoperative nausea and vomiting, and epidural problems. In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential recovery-related situation are given and elaborated upon. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

Metabolic and endocrine

2020 ◽  
pp. 271-329
Author(s):  
Hannah Blanshard
Keyword(s):  
Risk Factors ◽  
Liver Failure ◽  
Management Strategies ◽  
Online Resources ◽  
Disseminated Intravascular Coagulopathy ◽  
Sodium Potassium ◽  
Low Sodium ◽  
Turp Syndrome ◽  
Intravascular Coagulopathy ◽  
Calcium And Magnesium

This chapter deals with a plethora of metabolic and endocrine abnormalities from an anaesthetic perspective. Major biochemical cation derangements are covered including high and low sodium, potassium, calcium, and magnesium levels. Guidelines are also presented for the management of anaphylaxis/severe allergy, diabetic ketoacidosis, and hyperosmolar non-ketotic coma, malignant hyperthermia, porphyric crisis, thyrotoxic storm, phaeochromocytoma, Addisonian crisis, disseminated intravascular coagulopathy, hypoglycaemia, acute liver failure, sickle cell crisis, TURP syndrome, and hypothermia. In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential metabolic and endocrine-related situation are given and elaborated upon. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

Airway

2020 ◽  
pp. 79-117
Author(s):  
Jules Cranshaw ◽  
Tim Cook
Keyword(s):  
Risk Factors ◽  
Management Strategies ◽  
Rapid Sequence Induction ◽  
Tracheal Extubation ◽  
Online Resources ◽  
Mask Ventilation ◽  
Endobronchial Intubation ◽  
Rapid Sequence ◽  
Sequence Induction ◽  
Oesophageal Intubation

This chapter covers the guidelines for airway emergencies in anaesthesia. Strategies, checklists, and flowcharts are presented for the management of unexpected difficult mask ventilation and difficult intubation, e.g. ‘Cannot intubate, cannot oxygenate’ (CICO) and front of neck airway (FONA), partial airway obstruction, rapid sequence induction, laryngospasm, endobronchial intubation, oesophageal intubation, aspiration, airway fire, and difficult tracheal extubation. Definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations (e.g. paediatric implications) for each airway-related situation are covered. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

scholarly journals Placenta praevia in Najran University hospital: incidence and risk factors

2017 ◽  
Vol 6 (5) ◽  
pp. 1758
Author(s):  
Sana B. Mustafa ◽  
Abdulhadi M. Elbashir ◽  
Adil Y. Waddad ◽  
Abdelrahman M. A. Ibrahim
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Significant Risk ◽  
Placenta Praevia ◽  
University Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Care Clinic ◽  
One Year ◽  
The Impact

Background: Placenta praevia is a source of drastic pregnancy, fetal and neonatal complications. There was variable incidence in the literature in different parts of the world and within the same country regions. We carried out this study to find the impact in our area and the possible risk factors for this serious obstetric problem.Methods: This study is a cross-sectional descriptive, one-year retrospective one-year prospective study, carried out from April 2014 to April 2016. All pregnant women attended the antenatal care clinic in Najran University Hospital during the study period, were included.Results: The incidence of placenta praevia was found to be 2.7%. AMONG the study group, the most affected age group was between 20-29 years. Previous placenta praevia and previous caesarean  section were the significant risk factors P=0.00 and 0,017 repectively.Conclusions: The incidence of placenta praevia in Najran KSA in this study was high, compared to other regions in Saudi Arabia and the majority of the international figures. Caesarean section and previous placenta praevia were the significant risk factors for placenta praevia in this study.

scholarly journals Neonatal and Maternal Complications of Placenta Praevia and Its Risk Factors in Tikur Anbessa Specialized and Gandhi Memorial Hospitals: Unmatched Case-Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Ashete Adere ◽  
Abay Mulu ◽  
Fikremelekot Temesgen
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Blood Transfusion ◽  
Maternal Age ◽  
Case Control Study ◽  
Advanced Maternal Age ◽  
Case Control ◽  
Placenta Praevia ◽  
Maternal Complications ◽  
Control Study

Background. Placenta praevia is a disorder that happens during pregnancy when the placenta is abnormally placed in the lower uterine segment, which at times covers the cervix. The incidence of placenta praevia is 3-5 per 1000 pregnancies worldwide and is still rising because of increasing caesarean section rates. Objective. To assess and identify the risk factors and maternal and neonatal complications associated with placenta praevia. Method and Materials. Target populations for this study were all women diagnosed with placenta praevia transvaginally or transabdominally either during the second and third trimesters of pregnancy or intraoperatively in Tikur Anbessa Specialized and Gandhi Memorial Hospitals. The study design was unmatched case-control study. Data was carefully extracted from medical records, reviewed, and analyzed. Unconditional logistic regression analysis was performed using adjusted odds ratios (AOR) with 95% confidence intervals. Results. Pregnancies complicated by placenta praevia were 303. Six neonatal deaths were recorded in this study. The magnitude of placenta praevia observed was 0.7%. Advanced maternal age (≥35) (AOR 6.3; 95% CI: 3.20, 12.51), multiparity (AOR 2.2; 95% CI: 1.46, 3.46), and previous history of caesarean section (AOR 2.7; 95% CI: 1.64, 4.58) had an increased odds of placenta praevia. Postpartum anemia (AOR 14.6; 95% CI: 6.48, 32.87) and blood transfusion 1-3 units (AOR 2.7; 95% CI: 1.10, 6.53) were major maternal complications associated with placenta praevia. Neonates born to women with placenta praevia were at increased risk of respiratory syndrome (AOR 4; 95% CI: 1.24, 13.85), IUGR (AOR 6.3; 95% CI: 1.79, 22.38), and preterm birth (AOR 8; 95% CI: 4.91, 12.90). Conclusion. Advanced maternal age, multiparity, and previous histories of caesarean section were significantly associated risk factors of placenta praevia. Adverse maternal outcomes associated with placenta praevia were postpartum anemia and the need for blood transfusion. Neonates born from placenta praevia women were also at risk of being born preterm, intrauterine growth restriction, and respiratory distress syndrome.

Paediatrics

2020 ◽  
pp. 119-153
Author(s):  
Daniel Lutman
Keyword(s):  
Risk Factors ◽  
Severe Asthma ◽  
Life Support ◽  
Management Strategies ◽  
Neonatal Resuscitation ◽  
Anaesthetic Management ◽  
Online Resources ◽  
Acute Severe Asthma ◽  
Dose Calculations ◽  
Equipment Size

This chapter on paediatrics starts by covering neonatal resuscitation and basic and advanced paediatric life support. It then moves on to discuss the anaesthetic management of children suffering from drowning, acute severe asthma, stridor, anaphylaxis, major trauma, burns, and sepsis. Tables are provided showing normal weights and physiological parameters, and guiding choice of equipment size for different age ranges. A drug formulary is included with dose calculations for commonly used medicines. Definitions, presentation, management strategies, investigations, risk factors, exclusions, and causes, and any special considerations for each potential paediatric-related situation are given. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

Emergency department problems

2020 ◽  
pp. 369-400
Author(s):  
Kath Sutherland ◽  
Jim Blackburn ◽  
Neil Rasburn
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Life Support ◽  
Management Strategies ◽  
Online Resources ◽  
Radiation Injuries ◽  
Level Of Consciousness ◽  
The Common ◽  
Common Problems ◽  
Support Guidelines

This chapter covers the common problems anaesthetists and intensive care physicians may be faced with when called to help in the emergency department. It contains guidelines for the treatment of major trauma, drug overdose (general principles and specific agents), major gastrointestinal bleeding, chemical/biological/radiation injuries, decreased level of consciousness, and sepsis. There is also a section on post-resuscitation care which supplements the life support guidelines already covered in Chapter 2 (adults) and Chapter 5 (paediatrics). In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential situation are given and elaborated upon. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

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