Intrapartum obstetric management

Levin, Heather; LaSala, Anita

doi:10.1053/j.semperi.2014.04.013

Cited by 5 publications

(6 citation statements)

References 53 publications

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“…If there is needed, a regional anesthesia should be performed 10-12 h after the last prophylactic dose of LMWH and 24 h after the last therapeutic dose of LMWH. If there are used prophylactic UFH doses (5000 units twice daily), regional anesthesia can be safely placed, but in cases which require higher doses (10,000 units twice daily or greater), an individual assessment is usually necessary [65][66][67].…”

Section: Prevention Of Seizuresmentioning

confidence: 99%

Cerebral Vein and Dural Sinus Thrombosis

Jianu¹,

Jianu²,

Munteanu³

et al. 2018

Ischemic Stroke of Brain

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Cerebral venous thrombosis (CVT) is an uncommon disorder in the general population. At least 1 risk factor can be identified in 85% of patients with CVT. Because of the high frequency of thrombophilia among patients with CVT, screening for hypercoagulable conditions should be performed. Two pathophysiological mechanisms contribute to their highly variable clinical presentation. Four major syndromes have been described: isolated intracranial hypertension, focal neurological abnormalities, seizures, and encephalopathy. Cavernous sinus thrombosis represents the single CVT which produces a characteristic clinical syndrome. Head Computed Tomography is the most frequently performed imaging study, but Magnetic Resonance Imaging of the head combined with Magnetic Resonance venography are the most sensitive studies. Acute phase therapy for CVT focuses on anticoagulation, management of seizures, increased intracranial pressure, and prevention of cerebral herniation. The majority of patients have a complete or partial recovery, however they have an increased incidence of venous thromboembolism. Clinical and imaging follow-ups 3-6 months after diagnosis are recommended to assess for recanalization.

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Section: Prevention Of Seizuresmentioning

confidence: 99%

Cerebral Vein and Dural Sinus Thrombosis

Jianu¹,

Jianu²,

Munteanu³

et al. 2018

Ischemic Stroke of Brain

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“…As decisões em relação à época de resolução da gravidez e via de parto em mulheres portadoras de cardiopatia ainda são objeto de debates na literatura 57,58 . Quanto à época do parto, a conduta dependerá das condições maternas e fetais.…”

Section: Assistência Ao Parto E Puerpériounclassified

“…Em relação à via de parto, existe tendência à indicação liberal de cesarianas nessa população (mesmo sem evidências), por medo das alterações hemodinâmicas ligadas ao trabalho de parto e período expulsivo 58 . Entretanto, em cesáreas existe maior risco de perda sanguíneas, infecções e fenômenos tromboembólicos, o que devem ser levados em conta no momento de sua indicação.…”

Section: Assistência Ao Parto E Puerpériounclassified

“…Entretanto, em cesáreas existe maior risco de perda sanguíneas, infecções e fenômenos tromboembólicos, o que devem ser levados em conta no momento de sua indicação. Excetuando-se algumas poucas situações, a via de parto é indicada pelas condições obstétricas 52,56,58 . As indicações de cesárea por motivos cardiológicos estão reservadas às pacientes com risco de dissecção de aorta (coarctação de aorta, ou síndrome de Marfan com diâmetro de aorta ascendente superior a 40 mm), e em pacientes sob anticoagulação oral no momento do parto (pelo risco de sangramento cerebral fetal decorrente dos fenômenos plásticos do parto).…”

Section: Assistência Ao Parto E Puerpériounclassified

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Cardiopatia e gravidez

Testa

Borges

Bortolotto

2018

Rev. Med. (São Paulo)

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A assistência às pacientes cardiopatas passou por enormes avanços nas últimas décadas. Apesar da queda morbidade, a gravidez nesse grupo representa importante causa de mortalidade materna e de pior prognóstico fetal, mesmo em países desenvolvidos. O acompanhamento obstétrico dessas pacientes precisa ser individualizado conforme a estratificação de risco materno. Há poucos ensaios clínicos randomizados, sendo que a maior parte das condutas é baseada em estudos retrospectivos.Neste artigo realizamos uma revisão de literatura para embasar as melhores práticas na assistência multidisciplinar durante o ciclo gravídico puerperal das pacientes portadoras de cardiopatia.

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“…Neuraxial analgesia is the most effective method of labor analgesia and supported by the American College of Obstetricians and Gynecologists (ACOG) [9]. Excellent pain relief can be especially important in providing hemodynamic stability during the first stage of labor for parturients with cardiovascular comorbidities, as well as providing analgesia for an assisted second stage of delivery [4,10]. However, a patient may have a contraindication to a neuraxial technique that may or may not be related to the patient's high-risk condition.…”

Section: Multidisciplinary Delivery Planning Of High-risk Antepartum mentioning

confidence: 99%

Obstetric Anesthesiologists as Perioperative Physicians: Improving Peripartum Care and Patient Safety

Moaveni

Cohn

Zahid

et al. 2015

Curr Anesthesiol Rep

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The care of obstetric patients has become challenging due to the changing demographics of the pregnant population. Women with chronic diseases and congenital heart disease live to child-bearing age due to medical and surgical advances. Older and less healthy women become pregnant due to advances in reproductive technologies. Therefore, obstetric anesthesiologists have an increasingly important role in the peripartum period. In this article, we review the role of obstetric anesthesiologists in the antepartum, intrapartum, and postpartum periods. The need for multidisciplinary care of high-risk parturients is discussed, including the role of anesthesiologists in the National Maternal Health Initiative to improve maternal morbidity and mortality.

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Intrapartum obstetric management

Cited by 5 publications

References 53 publications

Cerebral Vein and Dural Sinus Thrombosis

Cerebral Vein and Dural Sinus Thrombosis

Cardiopatia e gravidez

Obstetric Anesthesiologists as Perioperative Physicians: Improving Peripartum Care and Patient Safety

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