scholarly journals Removal of a Giant Cyst of the Left Ovary from a Pregnant Woman in the First Trimester by Laparoscopic Surgery under Spinal Anesthesia during the COVID-19 Pandemic

2021 ◽  
Vol 9 (4) ◽  
pp. 70
Author(s):  
Attila Louis Major ◽  
Kudrat Jumaniyazov ◽  
Shahnoza Yusupova ◽  
Ruslan Jabbarov ◽  
Olimjon Saidmamatov ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Ovarian Cyst ◽  
Medical Center ◽  
Body Position ◽  
First Trimester ◽  
Left Ovary ◽  
Proper Position ◽  
Giant Cyst ◽  
Adverse Pregnancy

This paper reports a case of a 21 year old primigravida at 6 weeks gestation, suffering from important abdominal pain, who was admitted into the medical center with a giant cyst of 28 × 20 cm on her left ovary. A torsion of the ovarian cyst was suspected. Her COVID-19 status was unknown. In view of the emergency of the situation and the COVID-19 pandemic, laparoscopy in spinal anesthesia was performed. The patient remained conscious during the surgical intervention and tolerated it well apart from a slight dyspnea, which was easily eliminated by changing her body position and decreasing the pneumoperitoneum pressure. The ovarian cyst was removed by enlarging the trocar incision. The patient recovered with neither incident nor pregnancy loss. COVID-19-related complications can induce adverse pregnancy outcomes. Under general anesthesia, patients with COVID-19 are at risk of severe pneumonia and of passing their infection to the medical personnel. To avoid such complications in non-specialized centers, laparoscopy should be performed in regional anesthesia. Laparoscopy in spinal anesthesia can be performed safely on pregnant patients by placing them in the proper position, using a low pneumoperitoneum, and monitoring the hemodynamics. During early pregnancy, general anesthesia induces a higher risk of teratogenic effects and of miscarriage.

Scenario of General Anesthesia for Cesarean Section in Rural Tertiary Care Center in High Altitude Karnali Academy of Health Sciences

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Ramesh Bhattarai ◽  
Rajiv Shah ◽  
Sita Dhakal ◽  
Pragya Malla ◽  
Srijana Sapkota
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
High Altitude ◽  
Spinal Anesthesia ◽  
Neonatal Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Health Sciences ◽  
Tertiary Care Center ◽  
Cord Prolapse

Background: General anesthesia for cesarean section is being less popular for cesarean section in present days but sometime general anesthesia is inevitable. The aim of the study is to assess the trends of general anesthesia, indications, clinical outcome in mother and fetus in high altitude setting of tertiary care center of Nepal. Methods: We conducted descriptive cross-sectional study all cases of cesarean section in Karnali Academy of health Sciences (KAHS) located at high altitude over three years period   in our institute. Data were retrieved from the hospital records during three fiscal year (Jan 1st 2017 to Jan Dec 31st 2019). The record of all the patients who underwent cesarean section under general anesthesia was reviewed for demographic details, indication of general anesthesia, trends for general and spinal anesthesia and maternal and neonatal outcome. Results: Out of total deliveries 2175, 309 (14.2%) cases account for cesarean section. Among them, 52 (17%) required general anesthesia . Eclampsia 19(36%) remain the major indication for General Anesthesia in cesarean section followed by failure of spinal anesthesia number 14 (26%) , cord prolapse six (12%), antepartam haemorrhage five (10%), spinal site infection four (8%), Khiphoscoliosis two(4%), Patients request  two (4%). Use for general anesthesia technique was consistent for three years with slow rise in use of spinal anesthesia . There was no any anesthesia related maternal mortality and nine intraoperative neonatal   Conclusions:  General anesthesia practices are consistently required in rural high-altitude setup. Eclampsia is the commonest indication followed by failure of spinal anesthesia and cord prolapse. Neonatal outcome is still not good.  

Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome

2002 ◽  
Vol 22 (9) ◽  
pp. 778-782 ◽  
Author(s):  
Yuval Yaron ◽  
Sigal Heifetz ◽  
Yifat Ochshorn ◽  
Ofer Lehavi ◽  
Avi Orr-Urtreger
Keyword(s):  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Adverse Pregnancy

Spinal anesthesia for pediatric urological surgery: Reducing the theoretic neurotoxic effects of general anesthesia

2017 ◽  
Vol 13 (4) ◽  
pp. 396-400 ◽  
Author(s):  
Emmett E. Whitaker ◽  
Brianne Z. Wiemann ◽  
Daniel G. DaJusta ◽  
Seth A. Alpert ◽  
Christina B. Ching ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Urological Surgery ◽  
Neurotoxic Effects

scholarly journals Selective spinal anesthesia for outpatient laparoscopy. V: Pharmacoeconomic comparisonvs general anesthesia

2001 ◽  
Vol 48 (3) ◽  
pp. 279-283 ◽  
Author(s):  
Colin R. Chilvers ◽  
Alison Goodwin ◽  
Himat Vaghadia ◽  
G. W. E. Mitchell
Keyword(s):  
General Anesthesia ◽  
Spinal Anesthesia

scholarly journals Influence of Spinal and General Anesthesia on Newborn’s Status

2015 ◽  
Vol 69 (2) ◽  
pp. 65-70
Author(s):  
Emilija Ivanov ◽  
Dafina Karadzova ◽  
Sotir Nikolovski ◽  
Atanas Sivevski ◽  
Kiro Curlinov ◽  
...  
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
Base Excess ◽  
Rocuronium Bromide ◽  
Apgar Scores ◽  
Ph Values ◽  
Vital Parameters

AbstractIntroduction. The number of caesarean sections has drastically increased and thus arose the idea to examine the effect of the type of anesthesia on the neonates. The objective was to compare vital parameters in the neonates, born under general and spinal anesthesia.Method. A total of 120 patients with need for caesarean section have been divided in two groups of 60, of which the first was lead in general and the second one in spinal anesthesia. The first one was given propophol (2.0-2.5 mg/kg/tt) and succinil colin (1-1.5 mg/kg/tt). The anesthesia was lead with fentanil 0,005 mg/kg/tt and rocuronium bromide 0.4-0.6 mg/kg/tt. O2:N2O was 3:3 l/min. The second group was lead in spinal anesthesia. 2-3 ml Bupivacain 0.5% was spinally applied between L2-L3. Apgar score was defined in the neonates in the first and fifth minutes. The acido-basic status of the neonate was examined through pH values in the blood and the base excess.Results. In the first minute after birth giving with Apgar, 8 newborns 37(61,67%) were born to the group of patients with SA and 29 (48.33%) to the group of patients with GA. In 11 (18.33%) newborns born to the patients led with SA had Apgar score of 9-10, while only 3 (5%) of the newborns born to the patients led with GA had Apgar score of 9-10. Similar ratio was noted in the fifth minute after birth. Ph of the newborns’ blood as well as the base excess (BE) demonstrated significantly lower values in the group of patients led with SA than in the group of patients led with GA. Ph = 7.33 vs 7.37; BE=-4.57±1.8 vs -2.96±2.3.Conclusion. The newborns from the second group had significantly higher Apgar scores than those in the first group. The newborns’ relative acidose (lower SpO2and BE) did not affect the newborns’ Apgar score in the first and fifth minute.

scholarly journals Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon

2021 ◽  
Vol 15 (4) ◽  
pp. e0009390
Author(s):  
Jamille Gregório Dombrowski ◽  
André Barateiro ◽  
Erika Paula Machado Peixoto ◽  
André Boler Cláudio da Silva Barros ◽  
Rodrigo Medeiros de Souza ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Multivariate Logistic Regression Analysis ◽  
Brazilian Amazon ◽  
First Trimester ◽  
Inflammatory Factors ◽  
Anthropometric Measures ◽  
First Trimester Of Pregnancy ◽  
Adverse Pregnancy ◽  
Angiopoietin 2

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.

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