Pulse oximetry-derived respiratory rate monitoring in pregnant women undergoing cesarean section

2020 ◽  
Vol 86 (4) ◽  
Author(s):  
Hideaki Ebana ◽  
Masahiro Murakawa ◽  
Yoshie Noji ◽  
Keisuke Yoshida ◽  
Jun Honda ◽  
...  
2016 ◽  
Vol 19 (5) ◽  
pp. E248-E254 ◽  
Author(s):  
Hasan Baki Altinsoy ◽  
Ozkan Alatas ◽  
Salih Colak ◽  
Hakan Atalay ◽  
Omer Faruk Dogan

Background: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. Methods: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period. We used levosimendan as a potent inodilator in all patients to increase feto-placental blood flow and fetal heart rhythm.Results: Median time to diagnosis was 23.8 h (range 11.7-120 h) and median time from diagnosis to arrival in the operating theater was 9.8 h (range 7.4-19.8 h). One patient with prosthetic heart valve thrombosis underwent concomitant cesarean section prior to cardiac surgery. In a young pregnant woman who had spontaneous dissection of the left anterior descending artery, on-pump beating heart coronary artery bypass grafting was performed without cross clamping. Two and three months after surgery, cesarean sections were performed without any complication in two pregnant women.Conclusion: Because unusual cardiovascular complications are the main cause of maternal and/or fetus death during pregnancy, prompt and exact diagnosis is very important. Life-saving surgical strategy with the help of appropriate teams are necessary to optimize outcome for both mother and baby.


2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Junnosuke Kimura ◽  
Kento Kawamura ◽  
Manami Minoura ◽  
Ayako Hiramoto ◽  
Yoshifumi Suga ◽  
...  

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.


2016 ◽  
Vol 103 (6) ◽  
pp. 603-605 ◽  
Author(s):  
Paul Seddon ◽  
Sonia Sobowiec-Kouman ◽  
David Wertheim

Respiratory rate (RR) is a valuable early marker of illness in vulnerable infants, but current monitoring methods are unsuitable for sustained home use. We have demonstrated accurate measurement of RR from brief recordings of pulse oximeter plethysmogram (pleth) trace in full-term neonates in hospital. This study assessed the feasibility of this method in preterm infants during overnight recordings in the home. We collected simultaneous overnight SpO2, pleth and respiratory inductive plethysmography (RIP) on 24 preterm infants in the home. RR from pleth analysis was compared with RR from RIP bands; pleth quality was assessed by the presence of visible artefact. Median (range) RR from RIP and pleth were not significantly different at 42 (25–65) and 42 (25–64) breaths/min. Median (range) % of epochs rejected due to artefact was 20 (8–75) for pleth and 10 (3–53) for RIP. Our results suggest that home RR monitoring by pulse oximeter pleth signal is accurate and feasible.


2021 ◽  
Vol 28 (5) ◽  
pp. 993
Author(s):  
Kazim Gemici ◽  
Mustafa Uylas ◽  
Ramazan Gundogdu ◽  
Husnu Alptekin

2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.


2020 ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi

Abstract Background: Cesarean section is an important surgical procedure to save mothers and/or babies’ lives. Current trends show that the rate of Cesarean section is increasing dramatically over the years. The aims of this study were to compare the effects of "motivational interviewing" and "information, motivation and behavioral skills” model on choosing mode of delivery among pregnant women.Methods: In a four-armed, parallel-design randomized controlled trial, 120 women were randomly assigned to three brief interventions and one control groups. We recruited pregnant women referring to Ebnesina hospital, Tehran- Iran from 2019-2020. The intervention groups included: 1) motivational interviewing; 2) face-to-face information, motivation and behavioural skills model; and 3) information, motivation and behavioural skills model provided using a mobile application. The inclusion criteria were being literate, gestational age 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for CS, and having enough time to participate in the study. The most important outcomes of the study included women’s intentions to undergo any mode of delivery, women’s self-efficacy in choosing the mode of delivery, and mode of delivery. Data were analyzed using descriptive statistics (mean, frequency and standard deviation), inferential statistics including independent t-test, paired t-test, Chi-squared and One-way ANOVA tests and logistic regression.Results: Following the interventions, significant differences were found in the mode of delivery (P < 0.05) and women’s self-efficacy and intention (P < 0.05). Women who had used the mobile application had more improvements in the self-efficacy and intention than the face-to-face intervention groups.Conclusions: Our study showed positive significant effects of various types of brief interventions to reduce unnecessary Cesarean section rate among the participant women. Providing the intervention using mobile application showed even better results. Our findings may contribute to a rise in normal vaginal delivery; and these simple, non-expensive, tailored to women, and culture-oriented brief interventions can be considered as appropriate strategies to reduce Cesarean section rate in local, national, and/or regional levels.Trial registration: This study has been registered in Iran Randomized Clinical Trial Center (IRCT20151208025431N7). Registered October 07, 2018.


2019 ◽  
Vol 23 (3) ◽  
pp. 283-289
Author(s):  
Y. A. Revzoeva ◽  
E. Y. Shakurova

The article defines the significance and relevance of the problem of endometriosis during pregnancy. 10% of women in the reproductive period have different localization of endometriosis. 25% of pregnancies with endometriosis are complicated by preterm labor. The article presents a clinical case of intra-abdominal bleeding in a 28-year-old pregnant woman with retrocervical endometriosis at gestation age of 32 weeks and 6 days. The article covers the results of examination and special diagnostic procedures of intra-abdominal bleeding in pregnant women with retrocervical endometriosis. The main diagnostic methods were the study of past medical history, ultrasound examination, and laboratory tests. Due to their infrequency during pregnancy internal bleedings present difficulties in their diagnosis. Ultrasound reliably revealed a large amount of fluid in the abdominal cavity and small pelvis and excluded the presence of intrauterine bleeding. Clinical and laboratory tests indicated the severity of the patient's condition. Symptoms of moderate fetal distress were also identified. Therefore, a decision was made about an emergency delivery by the cesarean section followed by an abdominal revision. During the cesarean section, 500 ml of blood in the form of dark blood clots was found in the abdominal cavity. The condition of the premature newborn was in conformity with his gestational age. The source of bleeding were the of endometriosis on the back wall of the uterus. These focuses most likely caused hemoperitoneum. The revision of the abdominal cavity did not find any other foci of bleeding. The postoperative period was uneventful. The article provides general guidelines for the management of pregnant women with severe forms of endometriosis.


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