1/4. Severe fetal bradycardia in a pregnant surgical patient despite normal oxygenation and blood pressure.PURPOSE: To report and discuss a case of fetal bradycardia in a parturient under anesthesia for cholecystectomy despite normal maternal oxygenation and arterial blood pressure. CLINICAL FEATURES: A 27-yr-old woman (gravida 2 para 1), with a fetus of 34 weeks gestation, received general anesthesia for cholecystectomy. After anesthesia induction and tracheal intubation, anesthesia was maintained with oxygen, sevoflurane and iv remifentanil infusion. While preparing for surgery, the fetal heart rate decreased within about half a minute to 70 beats x min(-1) and remained at that level. The maternal blood pressure, heart rate and oxygen saturation were normal. An emergency Cesarean delivery was performed. The infant had Apgar scores of 1 at one minute, 5 at five minutes, 7 at ten minutes and required resuscitation after birth. CONCLUSION: Ideally, women having non-obstetric surgery during the third trimester of pregnancy will have intraoperative fetal heart rate monitoring.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/4. Tracheal plugs in oligohydramnios.Obstruction of the tracheobronchial tree in the fetus-newborn is well recognized with meconium-stained amniotic fluid, but this problem is not usually considered in the absence of meconium. In the case reported here, airway obstruction by a large mucous-like plug apparently developed in the context of severe oligohydramnios and fetal distress. The infant required resuscitation but it was initially impossible to expand the chest despite endotracheal intubation and positive pressure ventilation. The lung compliance changed abruptly at 6 minutes of age and breath sounds were audible unilaterally on the left. A chest radiograph confirmed an atelectatic right lung. After aspiration of a large plug, both lungs became normally aerated. airway obstruction must be included in the differential diagnosis of respiratory distress occurring in the context of severe oligohydramnios.- - - - - - - - - - ranking = 0.16666666666667keywords = pressure (Clic here for more details about this article) |
3/4. Fetal hazards of the intrauterine pressure catheter: five case reports.Five patients with fetal complications associated with the use of an intrauterine pressure catheter in labour are described. In four, a fetal vessel was punctured either by the catheter or its introducing sheath. In the remaining patient, cord compression resulted from entanglement with the catheter. These problems may be minimized by a careful catheter introduction technique.- - - - - - - - - - ranking = 0.83333333333333keywords = pressure (Clic here for more details about this article) |
4/4. Perforation of a placental fetal vessel by an intrauterine pressure catheter.Perforation of a fetal vessel on the placental surface by an intrauterine catheter is reported. The immediate recognition of this unusual complication is important. To minimize the risks of perforation, haemorrhage and infection, several precautions should be observed when inserting the catheter.- - - - - - - - - - ranking = 0.66666666666667keywords = pressure (Clic here for more details about this article) |