Regional anaesthesia in pregnant women with cardiovascular diseases

Background. Currently in developed countries, up to 4 % of pregnant women have cardiovascular diseases, which are one of the leading causes of maternal mortality. Anesthesia method have an important role in the abdominal delivery in this category of patients. Objective. To summarize the experience of different anesthesia approaches to abdominal delivery in pregnant women with cardiovascular diseases.Materials and methods. A retrospective analysis of the use of various methods of anesthesia during abdominal delivery of pregnant women with cardiovascular diseases was performed.Results. In “Maternity Hospital № 13” and the Almazov National Medical Research Centre for the period from 2014 to 2018 2140 abdominal deliveries were carried out in pregnant women with heart diseases (1450 and 690, respectively). In the Maternity Hospital №13 1374 (94.8 %) of abdominal deliveries were performed under regional anesthesia, 76 (5.2 %) under general anesthesia. In Almazov National Medical Research Centre 513 (74.3 %) of abdominal deliveries were performed under regional anesthesia, 177 (25.7 %) under general anesthesia. The features of the hemodynamic profile of general and regional anesthesia in pregnant women with various heart disease are presented.Conclusion. In pregnant women with heart disease, up to 88 % of cesarean section are performed under regional anesthesia. General anesthesia is used for contraindications to regional anesthesia, as well as for obstetric indications. The use of advanced monitoring, methods of slow titration of local anesthetic dose and the use of vasopressors allow to avoid hemodynamic disorders in patients with concomitant heart disease.

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Infectious safety during primary specialized accreditation in the COVID-19 pandemic

Virtual Technologies in Medicine ◽

10.46594/2687-0037_2021_1_1288 ◽

2021 ◽

pp. 14-20

Author(s):

Evgeny Germanovich Ripp ◽

A. R. Fattakhov ◽

T. M. Ripp ◽

R. A. Postanogov ◽

N. M. Iminov ◽

...

Keyword(s):

Medical Education ◽

Medical Research ◽

Research Centre ◽

Face To Face ◽

Technological Processes ◽

Specialized Accreditation ◽

National Medical ◽

Technical Personnel ◽

The Face ◽

Simulation Center

This article is devoted to the organization of the work of the Accreditation and Simulation Center of the Institute of Medical Education of the Almazov National Medical Research Centre during the primary specialized accreditation in the COVID-19 pandemic. Organizational solutions, technological processes and routing of accredited (308 people), support and technical personnel (98 people) and employees of the Accreditation and Simulation Center (14 people) and members of accreditation commissions (67 people) are presented to ensure infectious safety and the effectiveness of the face-to-face practice-oriented stage of accreditation.

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Trends in Attitudes Towards Orofacial Cleft by Pregnant Women and Future Need for Cleft Care

Journal of Oral Health and Community Dentistry ◽

10.5005/johcd-7-3-134 ◽

2013 ◽

Vol 7 (3) ◽

pp. 134-136

Author(s):

P Kadagad ◽

P Pinto

Keyword(s):

Medical Research ◽

Pregnant Women ◽

Scale Up ◽

Prenatal Ultrasound ◽

Ultrasound Diagnosis ◽

Research Centre ◽

Obstetrics And Gynecology ◽

Orofacial Cleft ◽

Medical Termination Of Pregnancy ◽

Medical Termination

ABSTRACT AIM To investigate the attitude of pregnant women towards prenatal ultrasound diagnosis of orofacial cleft and its impact on the future needs of cleft treatment. METHODS 100 subjects consulting the department of obstetrics and gynecology of KLE PK Hospital and Medical research centre were interviewed using a questionnaire. RESULTS Only 3 patients out of 100 patients chose the option of medical termination of pregnancy over continuation of pregnancy on prenatal ultrasound diagnosis of cleft. CONCLUSION Majority of pregnant women chose to continue pregnancy on prenatal ultrasound diagnosis of cleft; hence the implication to scale up the provision of future cleft therapy.

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STUDY OF THE STATE OF STRESS-IMPLEMENTING SYSTEMS IN ABDOMINAL DELIVERY DEPENDING ON ANESTHETIC TECHNIQUES

Wiadomości Lekarskie ◽

10.36740/wlek202011110 ◽

2020 ◽

Vol 73 (11) ◽

pp. 2378-2385

Author(s):

Marine A. Georgiyants ◽

Olena V. Vуsotska ◽

Nataliia P. Seredenko ◽

Tatiana V. Chernii ◽

Hanna N. Strashnenko ◽

...

Keyword(s):

Cesarean Section ◽

General Anesthesia ◽

Pregnant Women ◽

Pain Intensity ◽

Stress Hormones ◽

Anesthetic Techniques ◽

Protective Effects ◽

Sodium Thiopental ◽

State Of Stress ◽

Abdominal Delivery

The aim: Evaluation of stress-protective effects of various anesthetic techniques on Cesarean section (CS). Materials and methods: 127 pregnant women who delivered by cesarean section, were divided into 4 subgroups: 1a (n = 31) – general anesthesia (GA) with ketamine, 1b (n = 31) – GA with sodium thiopental, 2a (n = 31) – spinal anesthesia (SA), 2b (n = 34) – SA with intravenous administration of ondansetron at a dose of 8 mg. The assessment was performed at 5 stages: 1 – initial; 2 – infant extraction; 3 – 6 hours after surgery; 4 – 12 hours after surgery. Results: At stage 2, insulin levels in 1a and 1b subgroups decreased by 23.9% and 34.1%, while in 2a and 2b subgroups there were no significant changes. There was an increase in the levels of cortisol, prolactin and cortisol/insulin ratio at the 2 and 3 stages in the 1a and 1b subgroups. Pain intensity increased by the 3 stage in patients of all groups. It was the highest in the 1a and 1b subgroups. At the 4 stage, pain intensity was reduced in all groups, remaining significantly higher in patients of 1a and 1b subgroups. Conclusions: The dynamics of the content of stress hormones, the pain intensity in patients undergoing CS under SA give reason to consider this method as an optimal and adequate one for protection from surgery stress.

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Investigation of the Pregnant Women Desire to Choose the Type of Anesthesia during Cesarean Section in Imam Khomeini Hospital, Sari, Iran, in 2017

Journal of Surgery and Trauma ◽

10.32592/jsurgery.2021.9.2.106 ◽

2021 ◽

pp. 79-88

Keyword(s):

General Anesthesia ◽

Pregnant Women ◽

Regional Anesthesia ◽

Maternal Education ◽

Previous History ◽

P Value ◽

Chi Square ◽

Northern Iran ◽

Elective Cesarean ◽

Waking Up

Background: Type of anesthesia during elective cesarean is very important and is chosen according to the decision of the specialist as well as the mother’s desire. This study aimed to determine the rate and associated factors of choosing general or regional (spinal and epidural) anesthesia among pregnant women who underwent elective cesarean in hospitals of Northern Iran in 2017. Methods: This descriptive-analytic study included the pregnant women referred to the hospitals in Sari with indications for both kinds of anesthesia. The reasons for choosing the type of anesthesia were asked and collected in a researcher-made checklist. The collected data were described and analyzed using SPSS software (version 24) through the Chi-square or Fisher's exact tests and Logistic regression. A p-value less than 0.05 was considered statistically significant. Results: Out of 384 pregnant women who participated in the study, 60% and 40% of the cases chose general and regional anesthesia, respectively. Fear of spinal cord damage (64.3%) and fear of observing and hearing in the operation room (53.3%) were the most reasons for the rejection of the regional methods of anesthesia. However, the fear of not waking up (54.3%) and being interested in seeing the baby during childbirth (40.7%) were the main reasons for choosing spinal anesthesia. Most of the women who had experienced regional anesthesia selected this procedure in the current operation (53%), while general anesthesia was chosen by women without previous history of regional anesthesia (62%). Conclusion: Although most of the pregnant women selected general anesthesia, the reasons for rejecting the spinal method were mainly non-scientific and could be managed with maternal education.

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