Obstetric haemorrhage is the leading cause of mortality in parturients. In massive haemorrhage, fibrinogen is the first coagulation factor to decrease and a value < 2 gr/lt is a prognostic indicator of severe haemorrhage. A small decrease in fibrinogen leads to an increased effect on coagulability and continued haemorrhage. Coagulation disorders may be due to either consumption of coagulation factors or dilution. The type, severity and time of onset of the coagulation disorder depend on both the size and the cause of the haemorrhage. Early recognition of the cause of haemorrhage, low fibrinogen and its immediate correction are essential in the perioperative management of haemorrhage. Continue reading
Behçet’s Disease is a chronic autoimmune disorder manifesting mainly with mucocutaneous ulcers (mostly in the oral cavity and the genitalia), ophthalmic lesions and systemic vasculitis. Neuro-Behçet is a severe though rare form of the disease. Behçet’s Disease effect on pregnancy is controversial with higher rates of miscarriage, but with symptoms remission during peripartum period. Mouth scarring from ulcers can complicate general anesthesia rendering intubation impossible and neuro-Behçet’s CNS complications can avert general techniques. Here, we present the case of a C-section in a parturient with this uncommon disease and the anesthetic considerations. Literature review is also discussed. Continue reading
Turner syndrome is a genetic disorder that was first described by Ullrich in 19301, followed by a report of a 7-women series with the phenotype of turner syndrome, “short-stature and gonadal dysgenesis”, by the American physician Henry Turner in 19382. The main phaenotypical characteristics of Turner syndrome are the short stature which is prevalent in approximately 9 out of 10 cases, the zygomandibular abnormalities, cardiovascular abnormalities, endocrine, and reproductive dysfunctions3. Continue reading
The novel coronavirus disease 2019 (COVID-19) caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global health emergency since its declaration as a pandemic by the World Health Organization. Advanced maternal age is considered a high-risk pregnancy and therefore may affect the severity of Covid-191. Data regarding the management and outcome of a cesarean section in an extremely increased aged woman with Covid-19 disease are limited to a few case reports. In this case report, we discuss the perioperative management of an in vitro fertilization (IVF) cesarean section in a 48-year-old woman with Covid-19 infection. Continue reading
The number of pregnant women with morbid obesity (BMI 40–49.9 kg/m2) has significantly increased worldwide. Management of these patients presents a challenge for obstetric anesthesiologist. We report our management of cesarean delivery in a parturient with a BMI 47.3 kg/m2. We present this case to emphasize usefulness of Tuohy needle as an introducer for performing spinal anesthesia with a long 27G pencil point needle. Literature review is discussed. Continue reading
Mitochondrial diseases represent a wide range of disorders caused by impairment of mitochondrial metabolism and energy production. We report a case of an uneventful perioperative management of a pregnant patient with early childhood-onset mitochondrial encephalopathy, attributed to a novel AIFM1 (Apoptosis-Inducing Factor, Mitochondrion-associated 1) mutation. After a multidisciplinary team consultation, it was decided to be posted for elective caesarean delivery at 36+2 weeks of gestation, under titrated combined spinal-epidural anaesthesia and multimodal analgesia. Unique anaesthetic challenges were to ensure normoglycaemia, normothermia and adequate hydration while avoiding perioperative stress and acidosis. Continue reading

Intrathecal drug administration extends beyond the purposes of anaesthesia, to therapeutic applications. Here, we describe the case of a patient with severe Systemic Lupus Erythematosus having affected multiple organs and had a meningococcal infection. She was treated with intrathecal antibiotic therapy resulting in a successful outcome.

Continue reading

The scope of this study was to investigate if changing the direction of the Whitacre 26G needle aperture in regional anaesthesia during planned caesarean section produces a difference in the dose-response curves of the level of subdural blockade achieved by ropivacaine 0.75% and a standard dose of opioid. One hundred and twenty healthy parturients were blindly randomised in two groups, with 5 subgroups of 12 women each.

Continue reading

We have assessed intubating conditions and haemodynamic changes in three groups of 30 ASA I or II patients after induction of anaesthesia with propofol 2 mg*kg-1, remifentanil 0.5 μg*Kgr-1 and rocuronium 0,6 mg*kg-1 (group R), propofol 2 mg*kg-1 and remifentanil 1.5 μg*Kgr-1 (group F) and propofol 2 mg*kg-1, remifentanil 1.5 μg*Kgr-1 and midazolam 0.015 mg*kg-1 (group M).

Continue reading
Language
Αναβάθμιση του Impact Factor

Archives
ATOM Feed
RSS Feed
RDF Feed
Creative Commons License