Cesarean delivery

Berghella, Vincenzo

doi:10.3109/9781841848259.013

Cited by 3 publications

(2 citation statements)

References 78 publications

(75 reference statements)

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“…Though both regional and general anaesthesia are acceptable for CS the use of general anaesthesia has fallen dramatically in high-income countries in the past few decades and is now used in less than 5% of CS 14 – 16 . The type of anaesthesia chosen for CS is dependent on numerous factors such as the urgency, indication of the operation, coexisting medical problems, maternal and obstetrician's preference, anticipated duration and difficulty of the procedure and the presence or absence of an in-situ epidural or spinal catheter 17 – 19 . There are many indications for general anaesthesia, some of which are failed regional anaesthesia, conditions where regional anaesthesia is contraindicated, maternal request and life-threatening fetal and/or maternal compromise that may occur with extra time incurred with a regional technique or where there is insufficient time for a regional technique 20 .…”

Section: Introductionmentioning

confidence: 99%

Type of anaesthesia for caesarean section and failure rate in Princess Marina Hospital, Botswana’s largest referral hospital

Kassa

Mkubwa²,

Shifa

et al. 2020

Afr H. Sci.

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Background: Caesarean Section (CS) is a mode of delivery to decrease maternal and perinatal morbidity and mortality. We aimed to determine the type of anaesthesia used for CS among live-birth deliveries; and the failure rate of spinal anaesthesia (SA) in Princess Marina Referral Hospital, Botswana. Methods: Women who underwent CS from May-December 2017 were enrolled in the study. Data were recorded from anaesthesia charts and abstracted using Excel spreadsheet. We established the type of anaesthesia used, comparing the rate of elective versus emergency indications, and failure rate of SA using STATA. Fisher’s exact test used to compare results. Results: Among 2775 live-birth deliveries, 30.2% (837/2775) was by CS. Of those, 95.2% (797/837) had had SA and 4.8% (40/837) were GA. Under SA, 27.4% (218/797) were elective, and 72.6% (579/797) were emergency. Under GA 10% (4/40) were elective and 90.0% (36/40) were emergency. The overall failure rate of SA was 2% (16/813), that is 0.9% (2/220) for elective and 2.4% (14/593) among emergency indications; Fisher’s exact test p = 0.2959. Conclusion: Our study demonstrated that single shot SA is the most commonly preferred type of anaesthesia for both elective and emergency CS. The overall failure rate of SA was less common in our settings than previously reported. Keywords: Caesarean section; types of anaesthesia; spinal failure.

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Section: Introductionmentioning

confidence: 99%

Type of anaesthesia for caesarean section and failure rate in Princess Marina Hospital, Botswana’s largest referral hospital

Kassa

Mkubwa²,

Shifa

et al. 2020

Afr H. Sci.

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“… 10 Thus, along with intermittent pneumatic compression while in the hospital followed by compression stockings after release, recommendations in selected high risk patients include LDA for 6 weeks after vaginal delivery and prophylactic dose LMWH and LDA for 6 weeks after cesarean delivery ( Table 1 ). 35 36 …”

Section: Search Strategymentioning

confidence: 99%

Management of Women with Antiphospholipid Antibodies or Antiphospholipid Syndrome during Pregnancy

2021

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Antiphospholipid syndrome (APS), which is characterized by the presence of antiphospholipid antibodies (aPL), is associated with increased risk of thrombosis and obstetric complications, including preterm delivery and recurrent pregnancy losses. APS shows diverse clinical manifestations and the risk of complications varies among clinical subtypes. Although these patients are usually treated with aspirin and anticoagulants, the optimal treatment in various clinical settings is unclear, as the risk of complications vary among clinical subtypes and the management strategy depends on whether the patient is pregnant or not. Also, there are unmet needs for the evidence-based, pregnancyrelated treatment of asymptomatic women positive for aPL. This review focuses on the management of positive aPL or APS in pregnant and postpartum women, and in women attempting to become pregnant. For asymptomatic aPL positive women, no treatment, low dose aspirin (LDA) or LDA plus anticoagulants can be considered during antepartum and postpartum. In obstetric APS patients, preconceptional LDA is recommended. LDA plus low molecular weight heparin is administered after confirmation of pregnancy. Vascular APS patients should take frequent pregnancy test and receive heparin instead of warfarin after confirmation of pregnancy. During pregnancy, heparin plus LDA is recommended. Warfarin can be restarted 4 to 6 hours after vaginal delivery and 6 to 12 hours after cesarean delivery. Most importantly, a tailored approach and patient-oriented treatment are mandatory.

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