Severe maternal bradycardia and asystole after combined spinal-epidural labor analgesia in a morbidly obese parturient

Pan, Peter H.; Moore, Christopher A.; Ross, Vernon H.

doi:10.1016/j.jclinane.2003.10.006

Cited by 14 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although unusual at 20 weeks of gestation, it may be explained by the combination of polyhydramnios, morbid obesity, the supine position and neuraxial anaesthesia induced sympathectomy. 1 Aortocaval compression symptoms had been present for several weeks. Attempts to maintain blood pressure consisted of left lateral tilt, fluid co-loading and aggressive vasopressor use.…”

Section: Ijoa 15-00114mentioning

confidence: 99%

Maternal collapse secondary to aortocaval compression

Murphy

McCaul

Thornton

2015

International Journal of Obstetric Anesthesia

View full text Add to dashboard Cite

Section: Ijoa 15-00114mentioning

confidence: 99%

Maternal collapse secondary to aortocaval compression

Murphy

McCaul

Thornton

2015

International Journal of Obstetric Anesthesia

View full text Add to dashboard Cite

“…In healthy parturients, the plasma, placental artery, and vein concentrations of atropine were determined after IV or intramuscular administration of 0.01 mg/kg atropine, showing faster distribution and elimination of atropine and higher mean peak maternal plasma levels for IV administration than those observed for intramuscular administration [12]. Therefore, IV atropine is more effective in emergencies like fetal distress [13]. A few interventions must be considered during intrauterine resuscitation in cases of fetal distress.…”

Section: Discussionmentioning

confidence: 99%

“…A few interventions must be considered during intrauterine resuscitation in cases of fetal distress. The first is change in position; use of the left lateral recumbent position or, if required, the right lateral or knee-elbow position can help the fetus [13,14]. The second is rapid fluid replacement and supplementation with 100% O 2 [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…The first is change in position; use of the left lateral recumbent position or, if required, the right lateral or knee-elbow position can help the fetus [13,14]. The second is rapid fluid replacement and supplementation with 100% O 2 [13,14]. The third is suppression of uterine contractions and an intra-amniotic infusion of warmed crystalloid solution [14].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intrauterine fetal bradycardia after accidental administration of the anesthetic agent in the subdural space during epidural labor analgesia -A case report-

Moon

Chon

Yang

et al. 2013

Korean J Anesthesiol

View full text Add to dashboard Cite

Subdural injection of epidural anesthesia is rare and is usually undiagnosed during epidural anesthesia causing severely delayed maternal hypotension, hypoxia, and fetal distress. A 38-year-old primiparous woman was administered epidural labor analgesia at 40+6 weeks' gestation, and developed progressive maternal respiratory depression, bradycardia, and hypotension after accidental subdural administration of the anesthetic agent. Furthermore, fetal distress occurred soon after administration. The patient was managed with oxygen, position changes, fluid resuscitation, and ephedrine. Intrauterine fetal resuscitation was successfully performed with atropine before cesarean section, and a healthy baby was delivered. Although subdural injection is uncommon, this case emphasizes the importance of anesthesiologists monitoring patients for a sufficient period after epidural labor analgesia, and being prepared to perform maternal or fetal resuscitation.

show abstract

“…However, there is a potential risk that previously injected epidural drugs may enter the intrathecal space after a combined spinal-epidural technique, resulting in maternal bradycardia and asystole [60].…”

Section: Reviewmentioning

confidence: 99%

Pathophysiological and perioperative features of morbidly obese parturients

Leykin

Pellis

2009

Expert Review of Obstetrics & Gynecology

View full text Add to dashboard Cite

The prevalence of obesity is increasing among pregnant women. The association between obesity and pregnancy can result in further limitation of parturient physiological reserve. Indeed, maternal obesity is associated with an increased risk of delivery and postpartum complications, and poses a number of additional challenges for both general and neuroaxial anesthesia. The higher complication rate and the presence of obesity-related co-morbidities concur in placing this population at high risk for anesthesia-related maternal morbidity and mortality. Bariatric surgery scheduled before gestation to allow effective weight reduction, reduces the overall perinatal outcome to levels comparable to the general population. This review provides an insight into the magnitude and pathophysiological features of obese parturients, maternal and neonatal associated risks, along with peculiar anesthesiological management strategies.Pathophysiological and perioperative features of morbidly obese parturients Expert Rev.

show abstract

Severe maternal bradycardia and asystole after combined spinal-epidural labor analgesia in a morbidly obese parturient

Cited by 14 publications

References 32 publications

Maternal collapse secondary to aortocaval compression

Maternal collapse secondary to aortocaval compression

Intrauterine fetal bradycardia after accidental administration of the anesthetic agent in the subdural space during epidural labor analgesia -A case report-

Pathophysiological and perioperative features of morbidly obese parturients

Contact Info

Product

Resources

About