scholarly journals Anesthesia for caesarean section in pregnant women with kyphoscoliosis: neuraxial or general?

Pain medicine ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 63-66
Author(s):  
Rostyslav Chaplynskyi ◽  
Andrii Horiainov ◽  
Anna Omelchenko-Seliukova
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Neuraxial Anesthesia ◽  
Anatomical Features

Аnesthetic management of cesarean section in pregnant women with severe kyphoscoliosis is quite debatable. It is believed that kyphoscoliosis is a contraindication to neuraxial anesthesia methods. The article presents a successful experience of spinal anesthesia in pregnant women with severe kyphoscoliosis. Authors believe that spinal anesthesia can be successfully performed in pregnant women with severe kyphoscoliosis – paramedian access at the L5–S1 level, due to the anatomical features of these vertebrae.

scholarly journals Anestesi Spinal untuk Seksio Sesarea pada Wanita Hamil dengan Obesitas Morbid

2021 ◽  
Vol 4 (1) ◽  
pp. 43-7
Author(s):  
Alfathah Bania Lubis ◽  
Tatat Agustian ◽  
Djoni Kusumah Pohan ◽  
Alexander Siagian
Keyword(s):  
Pregnant Woman ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
The Body ◽  
Obese Women ◽  
Anesthesia Technique ◽  
Morbid Obese

Obesitas adalah keadaan tubuh yang terjadi akibat akumulasi lemak yang abnormal atau berlebih sehingga dapat menimbulkan banyak implikasi klinis dalam tatalaksana anestesi. Wanita hamil dengan berat badan lebih dan obesitas merupakan kondisi yang berisiko tinggi dan terbukti berhubungan dengan peningkatan komplikasi dalam kehamilan. Wanita dengan obesitas sangat penting diberikan edukasi untuk menurunkan berat badan dalam merencanakan kehamilan dan perlu diinformasikan tentang peningkatan risiko termasuk persalinan dengan bedah sesar. Seorang wanita 34 tahun G2P0A1 hamil 41 minggu dengan obesitas morbid dengan tinggi badan 156 cm dan berat badan 124 kg dengan nilai indeks massa tubuh (IMT) 50,9 kg/meter2. Pasien menjalani seksio sesarea dengan teknik anestesi spinal, dengan puncture di L3-4 median, menggunakan obat levobupivakain 15 mg + fentanyl 25 mcg. Operasi berlangsung 1 jam 15 menit, perdarahan 350 ml, hemodinamik stabil. Lahir bayi laki-laki, BB 3100 gram, PB 51 cm, APGAR score 8-9-10. Pemilihan teknik anestesi pada wanita hamil dengan obesitas yang akan menjalani seksio sesarea dilakukan dengan jenis anestesi regional yaitu anestesi spinal dengan pertimbangan dapat mengurangi terpaparnya obat-obatan terhadap bayi, mengurangi risiko aspirasi pneumonia dan memungkinkan proses lahirnya bayi dalam keadaan ibu sadar, dapat digunakan untuk mengatasi nyeri pasca operasi, dan juga dapat menghindari risiko bila dilakukan dengan teknik anestesi umum. Simpulan: Wanita hamil dengan berat badan lebih dan obesitas perlu penilaian kondisi dan perencanaan anestesi yang tepat untuk menurunkan risiko seksio sesarea   Spinal Anesthesia for Caesarean Section in Pregnant Woman with Morbid Obese Abstract Obesity is a state of the body that occurs due to abnormal or excess fat accumulation that can cause many clinical implications in the management of anesthesia. Overweight and obese pregnant women are at high risk and have been shown to be associated with increased complications in pregnancy. Obese women are very important to be educated to lose weight in planning pregnancy and need to be informed about increased risks including delivery by cesarean section. A female, 34 years old G2P0A1, 41 weeks pregnant with morbid obese, 156 cm tall and weight of 124 kg, with BMI 50,9 kg/meter2. Carried out in spinal anesthesia technique with puncture in L3-4 median, using levobupivacain 15 mg + fentanyl 25 mcg. The operation lasted for 1 hour and 15 minutes, with 350 ml bleeding, hemodynamically stable. Born a baby boy, BW 3100 gram, BL 51 cm, APGAR score 8-9-10. Anesthesia technique for pregnant woman with obese who will undergo Caesarean Section is regional anesthesia type called spinal anesthesia with consideration to reduce drug intake for baby, lessen chance of pneumonia aspiration and enable birth process while mother still awake, can be used for overcome post-operation pain, and to avoid risk if done by general anesthesia. Conclusion: overweight and obese pregnant women need proper condition assessment and anesthetic planning to reduce the risk of cesarean section.

CLINICAL AND SUBCLINICAL CHARACTERICTIS AND PREGNANCY OUTCOME OF FETAL MACROSOMIA AT OBSTETRIC DEPARTMENT AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Birth ◽  
Fetal Macrosomia ◽  
Major Influence ◽  
Maternal Complications ◽  
Perineal Tear ◽  
History Of

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.

scholarly journals Influence of arterial hypertension on intrauterine development of the fetus

2018 ◽  
Vol 20 (2) ◽  
pp. 81-85
Author(s):  
K G Garayeva
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Arterial Hypertension ◽  
Pregnant Women ◽  
Congenital Malformations ◽  
Preventive Measures ◽  
Intrauterine Development ◽  
Perinatal Development ◽  
Appropriate Treatment

The results of monitoring the course of pregnancy in women suffering from arterial hypertension and preventive measures focused on problems associated with hypertension are analyzed. It is shown that hypertension does not occur in pregnant women under 18 years old, but with the increasing of age of pregnant women, its occurrence is sharply increased. It was revealed that arterial hypertension during pregnancy creates not only a threat of preeclampsia and eclampsia development, but also a threat of defective development of the fetus. It was found that 26 (46%) parturient women undergone cesarean section. In this case, in 12 (21%) pregnant pre-natal development of the fetus was abnormal. After giving birth, the women in childbirth were under the supervision of a cardiologist and received appropriate treatment. 25 (45%) of women had another pregnancy after the treatment. Among the re-pregnant women, who before the onset of pregnancy received treatment in a specialized cardiological clinic, only 5 (20%) were prescribed to caesarean section. The remaining 80% of parturients gave birth naturally. Stillbirth and spontaneous miscarriages were not observed. Out of 25 newborns, only 3 (12%) children were found to have congenital malformations. Thus, in women with arterial hypertension and receiving appropriate treatment in cardiology hospitals, the indications for cesarean section were 26% less, also there were 10% perinatal development defects less than in women who did not receive such a treatment. Consequently, pregnant women suffering from hypertension should be monitored not only by an obstetrician-gynecologist, but also by cardiologist, nephrologist, ophthalmologist and endocrinologist.

scholarly journals General versus Spinal Anesthesia During Caesarean Section; A Narrative Review

2019 ◽  
Author(s):  
Zahid Hussain Khan ◽  
Negar Eftekhar ◽  
Rafah Sabah Barrak
Keyword(s):  
Family History ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Comparative Study ◽  
General Anesthesia ◽  
Medical History ◽  
Spinal Anesthesia ◽  
Narrative Review ◽  
Included Patient

This research is a method review type, comparative study between the effects of General anesthesia versus those of spinal anesthesia during caesarean section on the newborns and the mother undergoing cesarean section. The variables considered in the study included patient family history, patient medical history, status of patient during pregnancy, age of patient, and emergency or planned cesarean. Both general and spinal methods of anesthesia had differing results in multiple aspects and effects both during and after the surgery. However, pros of spinal anesthesia topped those of general anesthesia and is therefore the more favorable method of anesthesia.

scholarly journals Anesthetic management of obese and morbidly obese parturients

2021 ◽  
Vol 16 (4) ◽  
pp. 313-321
Author(s):  
Sang Tae Kim
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Anesthetic Management ◽  
Operation Time ◽  
Rapid Onset ◽  
The Body ◽  
Morbidly Obese ◽  
Single Shot ◽  
Cesarean Sections

The prevalence of obese parturients is increasing worldwide. This review describes safe analgesic techniques for labor and anesthetic management during cesarean sections in obese parturients. The epidural analgesic technique is the best way to provide good pain relief during the labor phase and can be easily converted to a surgical anesthetic condition. However, the insertion of the epidural catheter in obese parturients is technically more difficult compared to that in non-obese parturients. The distance from the skin to the epidural space increases in proportion to the body mass index (BMI): 4.4 cm in mothers of normal weight and 7.5 cm in mothers with BMI 50 and above. Neuraxial blocks are the ideal anesthetic methods and gold standard techniques for cesarean section in pregnant women with obesity. Single-shot spinal anesthesia is the most common type of anesthesia used for cesarean sections. The advantage of single-shot spinal anesthesia is a dense-sufficient block of rapid onset. A combined spinal-epidural (CSE) anesthetic technique is also recommended as an attractive alternative method. In obese parturients, the operation time can be longer than expected, and therefore, the CSE technique provides the advantage of rapid onset and intense block for prolonged operation with postoperative pain control. The risk of postoperative complications is very high in obese parturients. Therefore, detailed communication of the parturient's medical condition and the details of surgery and anesthesia between the anesthesiologist and obstetrician is important prior to cesarean section in obese pregnant women.

scholarly journals Cesárea en el Hospital Verdi Cevallos Balda en el año 2015

2017 ◽  
Vol 1 (1) ◽  
pp. 41
Author(s):  
Juan Carlos Suárez Fernández ◽  
Andrea Patricia Chancay Mendoza ◽  
Virginia Fernández ◽  
Galo Marcelo Proaño Arias ◽  
Dadier Marrero González
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Well Being ◽  
Cephalopelvic Disproportion ◽  
Mortality And Morbidity ◽  
Palabras Clave ◽  
Integral Assessment ◽  
The City ◽  
The Universe

En los últimos años, el parto por cesárea ha aumentado en relación al parto transpelviano a nivel mundial,  lo  cual  constituye  una  problemática  de  salud,  teniendo  en  cuenta  su  asociación  con  la morbimortalidad de las pacientes y el incremento de los costes que representa. En este trabajo, se realizó un estudio observacional descriptivo en el Hospital Regional Doctor Verdi Cevallos Bal- da de la ciudad de Portoviejo, entre enero y diciembre de 2015, con el objetivo de determinar las indicaciones más frecuentes de la cesárea. El universo estuvo constituido por 3037 gestantes. La muestra fue de 1260 cesareadas que cumplieron con el criterio de inclusión como cesárea primiti- va, y de exclusión para las cesáreas iteradas y los partos transpelvianos. Los resultados mostraron que al 56,1% de las gestantes se les practicó cesárea. Dentro de los diagnósticos de la cesárea se observó predominio de la desproporción cefalopélvica con un 42,5% el compromiso de bienestar fetal con un 26,8% y la corioamnionitis un 0,1%, correspondiendo a las indicaciones maternas, fe- tales y ovulares respectivamente. Se concluyó que la indicación de cesárea, debe ser el resultado de una evaluación integral del estado maternofetal, sobre el que se decide la realización de este procedimiento quirúrgico. Palabras clave: Cesárea, cefalopélvica, bienestar fetal, corioamnionitis Abstract: In recent years, cesarean has risen in relation to the transpelvic delivery worldwide, which is a pro- blem of health, taking into account its association with mortality and morbidity of patients and the increased costs which they represent. In this work, a descriptive observational study was conducted in the Regional Hospital Doctor Verdi Cevallos Balda in the city of Portoviejo, from January to De- cember 2015 with the objective of determining the most frequent indications for cesarean section. The universe consisted of 3037 pregnant women. The sample was cesarean section 1260 that met the  inclusion  criteria  as  early  cesarean  section, and exclusion  for  iterated  transpelvic  deliveries and caesarean sections. The results showed that 56.1% of pregnant women underwent caesarean section.  Within  diagnoses  prevalence  of  caesarean  section cephalopelvic  disproportion  to  42.5% was observed, the commitment of fetal well-being for 26.8% and 0.1% for chorioamnionitis, corres- ponding to maternal, fetal indications and ovular respectively. It was concluded that the indication of cesarean section, must be the result of a integral assessment of the maternal-fetal state, on which the realization of this surgical procedure is decided. Key words: Cesarean, cephalopelvic, fetal well-being, corioamnionitis

Influence of the category of urgency of the caesarean section on the adaptive capabilities of pregnant and parturient women

2017 ◽  
pp. 10-15
Author(s):  
I.A. Usevych ◽  
◽  
V.L. Kolesnik ◽  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maximum Level ◽  
Psychological Problems ◽  
Control Group ◽  
Pregnancy And Childbirth ◽  
Adaptive Capabilities ◽  
Section Operation ◽  
History Of

Psychological problems during pregnancy and childbirth for today is a little studied subject of modern obstetrics. The possibilities for solving psychological problems that arise in cases of emergency obstetric situations are almost not used by Ukrainian specialists through the marriage of knowledge and skills to provide crisis psychological help to obstetric patients. The objective: to determine the level of psychoemotional load in pregnant and parturient women, depending on the category of urgency of cesarean section. Material and methods. The main group of the study was presented: 1 group - pregnant women, who had planned a cesarean section operation according to the ІV category of urgency and who had already had a caesarean section in the anamnesis; ІІ group – pregnant women who planned an operation according to the IV category of urgency and who had no previous caesarean section in their history; ІІІ group – pregnant and parturient women who underwent surgery, respectively, in the I–III category of urgency; Control group – 30 pregnant women in the period of 37–41 weeks of pregnancy. A survey was conducted using the questionnaires of J.Teylor, Ch.Spielberger and SAN-test. Results. On the eve of labor in pregnant women there is an increase in the psychoemotional load, which can be determined using the above questionnaires. There is a direct dependence on the category of urgency of cesarean section and the level of psychoemotional load. Also revealed the correlation dependence of the voltage of the adaptation reserves of the pregnant woman on the presence of a history of caesarean section. Conclusion. Almost 50 percent of pregnant women, in cases of cesarean section, respectively, 1–3 categories of urgency in the preoperative period have the maximum level of psychoemotional load according to the questionnaires used. Pregnant women who have undergone a caesarean section in anamnesis are more adapted and have less psycho-emotional stress than women who have a cesarean section for the first time. Key words: cesarean section, psychoemotional state, pregnancy, childbirth, scale J. Teylor, scale Ch. Spielberger, SAN-test.

scholarly journals Posicionamento do paciente para raquianestesia: construção e validação de álbum seriado

2018 ◽  
Vol 31 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Sarah de Lima Pinto ◽  
Kenya Waleria de Siqueira Coêlho Lisboa ◽  
Nelson Miguel Galindo Neto ◽  
Larissa Alves Sampaio ◽  
Mirna Fontenele de Oliveira ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Content Validity ◽  
Validity Index ◽  
Content Validity Index

Resumo Objetivo: Construir e validar álbum seriado educativo para gestantes que serão submetidas à cirurgia cesariana, acerca do posicionamento durante a raquianestesia. Métodos: Estudo metodológico realizado com a elaboração do álbum seriado, validação com 22 enfermeiros de centro cirúrgico, 22 anestesistas e 3 juízes da área de comunicação e posterior avaliação do material por gestantes. Utilizou-se o Level Content Validity Index superior a 0,8 para a validação de conteúdo e o teste binomial para verificação da proporção de concordância. Resultados: O álbum seriado possui 15 páginas, contém orientações sobre vantagens, desvantagens e posições para a raquianestesia. A média do Level Content Validity Index foi de 0,94 pelos enfermeiros, 0,93 pelos anestesistas e 0,97 pelos juízes da área de comunicação. Houve unanimidade pelas gestantes na aprovação do material. Conclusão: O álbum seriado foi construído e validado e pode ser utilizado pela enfermagem junto a gestantes que serão submetidas à cesariana sob raquianestesia. Abstract Objective: Construct and validate an educational flipchart for pregnant women who are to be submitted to a cesarean section on positioning during spinal anesthesia.

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