更新于：2024-11-01

Obstetrical complication of anesthesia

麻醉引起的产科并发症

更新于：2024-11-01

基本信息

别名

Obstetrical complication of anaesthesia、Obstetrical complication of anaesthesia, NOS、Obstetrical complication of anesthesia

+ [5]

简介-

关联

项与麻醉引起的产科并发症相关的药物

Meperidine Hydrochloride

盐酸哌替啶

靶点

Opioid receptors

作用机制

Opioid receptors激动剂

在研机构

Hospira, Inc. [+1]

原研机构

Pharma Holdings US, Ltd

在研适应症

麻醉 [+2]

非在研适应症-

最高研发阶段批准上市

首次获批国家/地区

美国

首次获批日期1942-11-10

项与麻醉引起的产科并发症相关的临床试验

CTRI/2024/08/072089 / Not yet recruitingN/A

Efficacy of level adjusted local anaesthetic dose for subarachnoid block in elective caesarean section -A randomised trial. - NIL

开始日期2024-08-26

申办/合作机构

Mahatma Gandhi Memorial Medical College

NCT06449066 / RecruitingN/AIIT

Infectious Complications Associated With the Use of Peri-partum Neuraxial Anaesthesia in Patients With Primary Immunodeficiencies

The purpose of this study is to evaluate if neuraxial anesthesia (epidural or intradural anesthesia) used during childbirth is associated with more frequent infectious complications in patients with primary immunodeficiencies (PID).

开始日期2024-08-08

申办/合作机构

Assistance Publique des Hôpitaux de Paris SA

CTRI/2024/06/069444 / Not yet recruiting临床4期IIT

Comparison of incidence of hypotension in height adjusted dose vs fixed dose of bupivacaine in spinal anesthesia in cesarean section: A randomised controlled trial - NIL

开始日期2024-07-15

申办/合作机构-

100 项与麻醉引起的产科并发症相关的临床结果

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100 项与麻醉引起的产科并发症相关的转化医学

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0 项与麻醉引起的产科并发症相关的专利（医药）

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项与麻醉引起的产科并发症相关的文献（医药）

2023-07-01·American Journal of Obstetrics & Gynecology MFM

Effectiveness of extended postpartum inpatient monitoring for hypertensive disorders of pregnancy to reduce the risk of readmission for preeclampsia with severe features

Article

作者: Perry, Anna C. ; Bronner, Baillie A. ; de los Reyes, Samantha ; Trowbridge, Patrice L. ; Waters, Thaddeus P. ; McCormick, Anna C.

BACKGROUNDPreeclampsia is an obstetrical disorder, which complicates 3% to 6% of pregnancies and contributes to 21.6% of readmissions in the postpartum period. The optimal strategy for inpatient monitoring of blood pressures to minimize readmissions for postpartum patients with hypertensive disorders is not known. We hypothesized that extended monitoring of postpartum patients with hypertensive disorders of pregnancy for at least 36 hours after the last blood pressure that was ≥150/100 mm Hg would result in decreased readmission rates for preeclampsia with severe features compared with those who were not observed by these blood pressure goals.OBJECTIVEThis study aimed to evaluate whether extended inpatient monitoring of postpartum patients with hypertensive disorders of pregnancy for at least 36 hours after their last blood pressure that was ≥150/100 mm Hg would improve readmission rates for preeclampsia with severe features within 6 weeks of delivery.STUDY DESIGNThis was a retrospective cohort study in patients with a singleton pregnancy and a diagnosis of a hypertensive disorder of pregnancy at their delivery admission or at any point during pregnancy who delivered 1 year before and 1 year after the implementation of extended inpatient monitoring of postpartum hypertension. The primary outcome was readmission for preeclampsia with severe features within 6 weeks of delivery. The secondary outcomes were length of stay during first admission, number of readmissions for any indication, intensive care unit admission, postpartum day at readmission, median systolic blood pressure in the 24-hour period before discharge, median diastolic blood pressure in the 24-hour period before discharge, intravenous antihypertensive medication required during first admission, and intravenous antihypertensive medication required during second admission. Univariable analysis was performed for the association between baseline maternal characteristics and the primary outcome. Multivariable analysis was performed, adjusting for baseline maternal characteristic differences between exposure groups.RESULTSA total of 567 patients met the inclusion criteria of which 248 patients delivered before and 319 delivered after the implementation of extended monitoring. For baseline characteristics, the extended monitoring group had a significantly higher proportion of patients who were non-Hispanic Black and Hispanic, more diagnoses of hypertensive disorders and/or diabetes mellitus at the time of admission for delivery, a difference in the distribution of hypertensive diagnoses at the time of discharge from the first admission, and fewer discharged patients from their first admission on labetalol than the preintervention group. In a univariable analysis of the primary outcome, there was a significantly increased risk of readmission for preeclampsia with severe features in the extended monitoring group (62.5% vs 96.2% of total readmissions; P=.004). In multivariable analysis, patients in the extended monitoring group were more likely to be readmitted for preeclampsia with severe features than patients in the preintervention group (adjusted odds ratio, 3.45; 95% confidence interval, 1.03-11.5; P=.044).CONCLUSIONExtended monitoring with a strict blood pressure goal of <150/<100 mm Hg did not decrease readmissions for preeclampsia with severe features in patients with a previous diagnosis of a hypertensive disorder of pregnancy.

2022-11-01·Alimentary Pharmacology & Therapeutics

Ustekinumab during pregnancy in patients with inflammatory bowel disease: a prospective multicentre cohort study

Article

作者: Kopylov, Uri ; Pauker, Maor H. ; Tzadok, Roie ; Granovsky, Sorina Grisaru ; Arazi, Ayelet ; Ron, Yulia ; Zinger, Adar ; Livne‐Margolin, Moran ; Mishael, Tali ; Zittan, Eran ; Avni‐Biron, Irit ; Ollech, Jacob E. ; Hadar, Eran ; Farkash, Rivka ; Shitrit, Ariella Bar‐Gil ; Yanai, Henit ; Helman, Sarit ; Goldenberg, Rosie ; Dotan, Iris

SummaryBackgroundWomen with inflammatory bowel diseases (IBD) often receive biologics to maintain remission during pregnancy.AimsTo assess maternal and neonatal outcomes in patients with IBD treated with ustekinumab (UST) during pregnancyMethodsIn a multicentre, prospective cohort study, we recruited women with IBD treated with UST during pregnancy between 2019 and 2021. Outcomes were compared among patients treated with UST, anti‐tumour necrosis factor α, (anti‐TNF) and non‐UST, non‐anti‐TNF therapies. UST‐treated patients were matched 1:2 to controls according to age, body mass index and parity. Newborns were followed up to 12 months.ResultsWe recruited 129 pregnant patients: UST 27; anti‐TNF 52; non‐UST, non‐anti‐TNF 50 (thiopurine or mesalazine 30, no therapy 20); Crohn's disease 25 (96.9%). Overall, pregnancy, neonatal and newborn outcomes were satisfactory, with no significant differences among patients treated with UST, anti‐TNF and non‐UST non‐anti‐TNF agents for obstetrical maternal complications [UST 3 (11.5%), anti TNF 12 (23.1%), non UST, non‐anti‐TNF 4 (8.2%), p = 0.095], pre‐term delivery [1 (4.3%), 9 (18.4%), 4 (5.7%), p = 0.133], low birth weight [1 (4.2%), 5 (10.2%), 4 (8.3%), p = 0.679], or first year newborn hospitalisation [2 (9.1%), 4 (8.2%), 3 (6.1%), p = 0.885].ConclusionPregnant patients with IBD treated with UST demonstrated favourable pregnancy and neonatal outcomes that were comparable with those in patients treated with anti‐TNF or other therapy. Data are reassuring for patients with IBD and their physicians when considering UST during pregnancy.

2022-04-01·The Breast2区 · 医学

Obstetric complications at time of delivery amongst breast cancer survivors: A population-based cohort study

2区 · 医学

ArticleOA

作者: Pillar, Nir ; Paluch-Shimon, Shani ; Yoeli-Ullman, Rakefet ; Kaidar-Person, Orit ; Lawrence, Yaacov R ; Poortmans, Philip

PURPOSEOur aim was to determine whether breast cancer survivors are at increased risk of obstetric and maternal complications at time of delivery.METHODSThe USA 'National Inpatient Sample' database was queried for hospitalizations associated with deliveries, between 2015 and 2018. The incidence of maternal and fetal complications was compared between women with, and without, a personal history of breast cancer.RESULTSOf the 2,103,216 birth related admissions, 617 (0.03%) of the women were breast cancer survivors, with the proportion increasing over time (from 0.02% in 2015 to 0.04% in 2018). Breast cancer survivors had a higher socioeconomic status (p < 0.001) and were significantly older compared to other mothers (34 vs. 28 years, p < 0.001). Additionally, they were more likely to suffer from preexisting chronic diseases including cardiopulmonary disease and diabetes mellitus, and had a higher incidence of multiple gestation (4.4% vs. 1.6%) [OR 2.7, 95% CI 1.9-4.0, p < 0.001]. The incidence of acute adverse events at time of delivery including fetal distress, preterm labor, cesarean section and maternal infection was higher amongst the breast cancer survivors. On multivariate analysis age, ethnic group, comorbidities, multiple gestations, and a previous breast cancer diagnosis, but not cancer treatment, were associated with an increased risk of an obstetric adverse event.CONCLUSIONBreast cancer survivors have more comorbidities and are at increased risk of acute obstetrical complications at time of delivery. Further studies are required to validate these findings, and evaluate the ability of interventions to improve obstetrical outcomes amongst breast cancer survivors.