Pub Date : 2024-10-28DOI: 10.1016/j.ijoa.2024.104289
M. Billeret , A. Blandinières , D. Touati , C. Desconclois , R. Garreau , A. Le Gouez , C. Lavenu-Bombled , M. Bruyère
{"title":"Moderate factor XI deficiency and neuraxial procedures in an obstetric cohort: a retrospective study (2014–2021)","authors":"M. Billeret , A. Blandinières , D. Touati , C. Desconclois , R. Garreau , A. Le Gouez , C. Lavenu-Bombled , M. Bruyère","doi":"10.1016/j.ijoa.2024.104289","DOIUrl":"10.1016/j.ijoa.2024.104289","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104289"},"PeriodicalIF":2.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1016/j.ijoa.2024.104288
A.Y.H. Kong , N. Liu , H.S. Tan , A.T.H. Sia , B.L. Sng
The use of artificial intelligence (AI) in obstetric anaesthesiology shows great potential in enhancing our practice and delivery of care. In this narrative review, we summarise the current applications of AI in four key areas of obstetric anaesthesiology (perioperative care, neuraxial procedures, labour analgesia and obstetric critical care), where AI has been employed to varying degrees for decision support, event prediction, risk stratification and procedural assistance. We also identify gaps in current practice and propose areas for further research. While promising, AI cannot replace the expertise and clinical judgement of a trained obstetric anaesthesiologist. It should, instead, be viewed as a valuable tool to facilitate and support our practice.
{"title":"Artificial intelligence in obstetric anaesthesiology – the future of patient care?","authors":"A.Y.H. Kong , N. Liu , H.S. Tan , A.T.H. Sia , B.L. Sng","doi":"10.1016/j.ijoa.2024.104288","DOIUrl":"10.1016/j.ijoa.2024.104288","url":null,"abstract":"<div><div>The use of artificial intelligence (AI) in obstetric anaesthesiology shows great potential in enhancing our practice and delivery of care. In this narrative review, we summarise the current applications of AI in four key areas of obstetric anaesthesiology (perioperative care, neuraxial procedures, labour analgesia and obstetric critical care), where AI has been employed to varying degrees for decision support, event prediction, risk stratification and procedural assistance. We also identify gaps in current practice and propose areas for further research. While promising, AI cannot replace the expertise and clinical judgement of a trained obstetric anaesthesiologist. It should, instead, be viewed as a valuable tool to facilitate and support our practice.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104288"},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-19DOI: 10.1016/j.ijoa.2024.104287
A. Brenders , T. Bleeser , J. Deprest , S. Rex , S. Devroe
{"title":"Effect of vasoactive drugs used for management of hypotension during pregnancy on uterine hemodynamic parameters: a systematic review and meta-analysis of preclinical and clinical studies","authors":"A. Brenders , T. Bleeser , J. Deprest , S. Rex , S. Devroe","doi":"10.1016/j.ijoa.2024.104287","DOIUrl":"10.1016/j.ijoa.2024.104287","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104287"},"PeriodicalIF":2.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.ijoa.2024.104283
H Saddouk, M Tajir, H Saadi, B Housni, N Zerrouki, N Zizi, S Dikhaye
{"title":"Pregnancy revealing hereditary angioedema type III with factor XII mutation managed in a resource-limited setting with no C1-inhibitor concentrate availability: a case report.","authors":"H Saddouk, M Tajir, H Saadi, B Housni, N Zerrouki, N Zizi, S Dikhaye","doi":"10.1016/j.ijoa.2024.104283","DOIUrl":"https://doi.org/10.1016/j.ijoa.2024.104283","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":" ","pages":"104283"},"PeriodicalIF":2.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.ijoa.2024.104282
Sharon C. Reale, Michaela K. Farber
{"title":"High flow nasal cannula: A new tool for obstetric pre-oxygenation","authors":"Sharon C. Reale, Michaela K. Farber","doi":"10.1016/j.ijoa.2024.104282","DOIUrl":"10.1016/j.ijoa.2024.104282","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104282"},"PeriodicalIF":2.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.ijoa.2024.104284
A. Faruja , A. Idelson , K. Azem , L. Yosef , K. Tenenbaum-Gavish , N.R. Duvdevani , S. Fein , S. Orbach-Zinger , Y. Gielchinsky
Fetal surgery presents distinctive anesthetic challenges due to the need to balance maternal and fetal safety. This retrospective study evaluates the anesthetic management strategies used at a single center for various fetal interventions, including fetoscopic laser photocoagulation, fetal endoluminal tracheal occlusion, bipolar cord coagulation, and fetoscopic spina bifida repair.
We reviewed 195 fetal procedures performed between 2019 and 2023 at Rabin Medical Center. Data collected included maternal and fetal characteristics, anesthetic techniques (spinal, combined spinal-epidural, general), intraoperative hypotension, and perioperative complications. We examined the evolution of anesthetic practice, particularly focusing on hemodynamic management and postoperative pain control.
Spinal anesthesia was increasingly preferred for shorter procedures such as fetoscopic laser photocoagulation and bipolar cord coagulation, while general anesthesia was used exclusively for spina bifida repair. Intraoperative hypotension was a significant issue, leading to the implementation of prophylactic phenylephrine infusions, which improved blood pressure control. A shift from volatile anesthesia to total intravenous anesthesia in spina bifida repair resulted in fewer complications, including reduced bleeding. Postoperative pain management was optimized with a multimodal approach, improving pain scores.
This study underscores the importance of tailoring anesthetic techniques to the specific fetal surgery. Key improvements in hypotension management, adopting total intravenous anesthesia for complex surgeries, and optimized postoperative pain control have contributed to better maternal and fetal outcomes. Ongoing reassessment and adaptation of anesthetic protocols remain critical as fetal surgery evolves.
{"title":"Anesthetic management for fetal surgery: Lessons from a single-center experience (2019–2023)","authors":"A. Faruja , A. Idelson , K. Azem , L. Yosef , K. Tenenbaum-Gavish , N.R. Duvdevani , S. Fein , S. Orbach-Zinger , Y. Gielchinsky","doi":"10.1016/j.ijoa.2024.104284","DOIUrl":"10.1016/j.ijoa.2024.104284","url":null,"abstract":"<div><div>Fetal surgery presents distinctive anesthetic challenges due to the need to balance maternal and fetal safety. This retrospective study evaluates the anesthetic management strategies used at a single center for various fetal interventions, including fetoscopic laser photocoagulation, fetal endoluminal tracheal occlusion, bipolar cord coagulation, and fetoscopic spina bifida repair.</div><div>We reviewed 195 fetal procedures performed between 2019 and 2023 at Rabin Medical Center. Data collected included maternal and fetal characteristics, anesthetic techniques (spinal, combined spinal-epidural, general), intraoperative hypotension, and perioperative complications. We examined the evolution of anesthetic practice, particularly focusing on hemodynamic management and postoperative pain control.</div><div>Spinal anesthesia was increasingly preferred for shorter procedures such as fetoscopic laser photocoagulation and bipolar cord coagulation, while general anesthesia was used exclusively for spina bifida repair. Intraoperative hypotension was a significant issue, leading to the implementation of prophylactic phenylephrine infusions, which improved blood pressure control. A shift from volatile anesthesia to total intravenous anesthesia in spina bifida repair resulted in fewer complications, including reduced bleeding. Postoperative pain management was optimized with a multimodal approach, improving pain scores.</div><div>This study underscores the importance of tailoring anesthetic techniques to the specific fetal surgery. Key improvements in hypotension management, adopting total intravenous anesthesia for complex surgeries, and optimized postoperative pain control have contributed to better maternal and fetal outcomes. Ongoing reassessment and adaptation of anesthetic protocols remain critical as fetal surgery evolves.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104284"},"PeriodicalIF":2.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.ijoa.2024.104277
Anthony Chau , Ilana Sebbag , Eduardo Sutherland , Giselle Villar
The clinical guidelines on postpartum hemorrhage from the Society of Obstetricians and Gynaecologists of Canada (SOGC) provide evidence-based recommendations structured around the 6Rs framework: Risk Assessment, Risk Reduction, Recognition and Evaluation, Reaction, Resuscitation, and Review. Since its publication, our institution has begun implementing all the guideline recommendations. One key recommendation is to calculate the Maximum Allowable Blood Loss (MABL) to reach a hemoglobin level of 70 g/L for every obstetric patient. This practice was introduced to promote an individualized approach to hemorrhage risk assessment, accounting for variations in patients’ anthropometric characteristics. However, there is currently a lack of evidence supporting the use of MABL calculation in the obstetric population. In this commentary, we highlight the limitations of the MABL calculation through specific examples and propose areas for further research.
{"title":"Obstetric hemorrhage risk assessment using the maximum allowable blood loss calculation: are we on the right track?","authors":"Anthony Chau , Ilana Sebbag , Eduardo Sutherland , Giselle Villar","doi":"10.1016/j.ijoa.2024.104277","DOIUrl":"10.1016/j.ijoa.2024.104277","url":null,"abstract":"<div><div>The clinical guidelines on postpartum hemorrhage from the Society of Obstetricians and Gynaecologists of Canada (SOGC) provide evidence-based recommendations structured around the 6Rs framework: Risk Assessment, Risk Reduction, Recognition and Evaluation, Reaction, Resuscitation, and Review. Since its publication, our institution has begun implementing all the guideline recommendations. One key recommendation is to calculate the Maximum Allowable Blood Loss (MABL) to reach a hemoglobin level of 70 g/L for every obstetric patient. This practice was introduced to promote an individualized approach to hemorrhage risk assessment, accounting for variations in patients’ anthropometric characteristics. However, there is currently a lack of evidence supporting the use of MABL calculation in the obstetric population. In this commentary, we highlight the limitations of the MABL calculation through specific examples and propose areas for further research.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104277"},"PeriodicalIF":2.6,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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