Books on the topic 'Obstetric Haemorrhage'
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1
Norman, Jane E., and Vicki Clark. Obstetric haemorrhage. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0035.
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Major obstetric haemorrhage affects around 0.4% of pregnant women, accounts for around 50% of intensive care unit admissions amongst pregnant women, and is a significant cause of maternal death. Optimal obstetric and anaesthetic management plays an important role in reducing mortality. Such management includes antenatal optimization (ensuring that pre-delivery haemoglobin is normal, and identifying risk factors such as placenta praevia), prompt recognition of bleeding and senior involvement, and debriefing for staff and patients after the event. This chapter focuses on the causes of, and treatments for, antenatal, intrapartum, and postpartum haemorrhage. Resuscitation and therapeutic (pharmacological and surgical) strategies are described and the use of blood products and cell salvage discussed from the point of view of both the anaesthetist and the obstetrician. Lastly, current controversies, including the use of recombinant factor VII and tranexamic acid are mentioned.
2
Waldmann, Carl, Neil Soni, and Andrew Rhodes. Obstetric emergencies. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199229581.003.0031.
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Pre-eclampsia 518Eclampsia 520HELLP syndrome 522Postpartum haemorrhage 524Amniotic fluid embolism 526Pre-eclampsia is a common complication of pregnancy, UK incidence is 3–5%, with a complex hereditary, immunological and environmental aetiology.Abnormal placentation is characterized by impaired myometrial spiral artery relaxation, failure of trophoblastic invasion of these arterial walls and blockage of some vessels with fibrin, platelets and lipid-laden macrophages. There is a 30–40%, reduction in placental perfusion by the uterine arcuate arteries as seen by Doppler studies at 18–24 weeks gestation. Ultimately the shrunken, calcified, and microembolized placenta typical of the disease is seen. The placental lesion is responsible for fetal growth retardation and increased risks of premature labour, abruption and fetal demise. Maternal systemic features of this condition are characterized by widespread endothelial damage, affecting the peripheral, renal, hepatic, cerebral, and pulmonary vasculatures. These manifest clinically as hypertension, proteinuria and peripheral oedema, and in severe cases as eclamptic convulsions, cerebral haemorrhage (the most common cause of death due to pre-eclampsia in the UK), pulmonary oedema, hepatic infarcts and haemorrhage, coagulopathy and renal dysfunction....
3
Prout, Jeremy, Tanya Jones, and Daniel Martin. Obstetric anaesthesia. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0024.
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This chapter covers the knowledge required for higher training in obstetric anaesthesia. Physiological changes of pregnancy, along with their relevance to anaesthetic management are highlighted. Common maternal comorbidity and the impact on antenatal course, delivery and anaesthesia are summarized. Modern labour analgesia techniques are compared. Anaesthetic management of common obstetric emergencies e.g. fetal distress, preeclampsia, massive haemorrhage, abnormal placentation, amniotic fluid embolus and uterine inversion are described. Finally, the recent Confidential Enquiry into Maternal Death is summarized along with the role of early warning scores to improve future care.
4
Beed, Martin, Richard Sherman, and Ravi Mahajan. Obstetric and fertility patients. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199696277.003.0013.
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Critical illness in pregnancySevere pre-eclampsia/eclampsiaHELLP syndromeAnaphylactoid syndrome of pregnancyMassive obstetric haemorrhageOvarian hyperstimulation syndromeAny critical illness may complicate pregnancy, or the postpartum period; especially sepsis and thromboembolic disease. Pregnancy-related illnesses may also require critical care intervention, including: pre-eclampsia and eclampsia, the HELLP syndrome, major haemorrhage, and anaphylactoid syndrome of pregnancy (amniotic fluid embolism). As with any critical illness, life-threatening problems are identified and treated first....
5
Collis, Rachel, Sarah Harries, and Abrie Theron, eds. Obstetric Anaesthesia. 2nd ed. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780199688524.001.0001.
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Starting work on the labour ward is very challenging for all junior anaesthetists. This handbook is an easily navigated practical reference guide for anaesthetists new to this environment, as well as other members of the labour ward multi-disciplinary team; midwives, obstetricians, and Consultant Anaesthetists who visit labour ward less frequently or only when on-call. It covers all aspects of obstetric anaesthesia that the trainee anaesthetist will encounter during their obstetric training module, and is essential reading for FRCA exam preparation. Since the first edition, there is no doubt that the pregnant population has become more complex, with increasing maternal age and BMI, and challenging co-morbidities presenting more frequently. As well as providing updates from recent MBRRACE reports and national guidelines, new techniques, drugs, and technology, such as point of care testing have been included. New chapters covering the application of ultrasound in obstetric anaesthesia, recognition of the sick and septic patient, maternal obesity and neonatal resuscitation have been introduced. Previous chapters, e.g. haemorrhage, have been extensively updated, with the latest management protocols and algorithms based on recent published research in obstetric bleeding. We have retained our practical guides to performing, managing, and trouble-shooting regional techniques that are more problematic on labour ward, and our extensive A–Z of rarer conditions has updated references. More conventional chapters on maternal physiology and pathophysiology provide readers with essential examination material. The importance of anticipating risk in the antenatal period through high risk anaesthetic assessment clinics and postpartum management of tricky neurological complications is also well covered.
6
Eldridge, James, and Maq Jaffer. Obstetric anaesthesia and analgesia. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198719410.003.0033.
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This chapter discusses the anaesthetic management of the pregnant patient, for labour analgesia as well as surgical intervention. It begins with a description of the physiological and pharmacological changes of pregnancy. It describes methods of labour analgesia, including remifentanil, and epidural analgesia and its complications such as post-dural puncture headache. It describes anaesthesia for Caesarean section (both regional and general), failed intubation, antacid prophylaxis, post-operative analgesia, retained placenta, in utero fetal death, hypertensive disease of pregnancy (pre-eclampsia, eclampsia, and the hypertension, elevated liver enzymes, and low platelets (HELLP) syndrome), massive obstetric haemorrhage, placenta praevia and morbidly adherent placenta (placenta accreta, increta, and percreta), amniotic fluid embolism, maternal sepsis, and maternal resuscitation. It discusses co-morbidity in pregnancy, such as obesity and cardiac disease, and the patient who requires non-obstetric surgery while pregnant. It provides information on safe prescribing in pregnancy and breastfeeding.
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Levinson, Andrew, and Ghada Bourjeily. Obstetric Disorders in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0367.
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Critical illness in pregnancy is a rare, but potentially catastrophic event for the mother and foetus. A thorough understanding of the effective management practices for the most common obstetrical reasons for ICU admission is essential for providing effective critical care to women in the ante-partum and immediate post-partum period. Some of the most common reasons for the need for critical care in the peripartum and post-partum period include venous thromboembolism, post-partum haemorrhage, amniotic fluid embolism, ovarian hyperstimulation syndrome, and obstetric sepsis. Management of these conditions should focus on choosing the most effective diagnostic and therapeutic measures for the mother, while focusing on minimizing foetal harm, accounting for physiological changes that may affect diagnostic strategies and pharmacokinetics.
8
Adam, Sheila, Sue Osborne, and John Welch. Endocrine, obstetric, and drug overdose emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.003.0014.
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This chapter discusses specific endocrine, obstetric, and drug overdose emergencies that necessitate admission to the critical care unit. First, the underlying physiology and management of endocrine disorders such as phaeocromocytoma, Addisonian crisis, diabetic emergencies (such as diabetic ketoacidosis), thyroid disorders, and calcium abnormalities are discussed. Secondly, the physiology and management of pregnancy-related problems are discussed including hypertensive disorders of pregnancy (such as pre-eclampsia), acute fatty liver of pregnancy, peri-partum cardiomyopathy, massive obstetric haemorrhage and amniotic fluid embolism. Finally, the management of drug overdose and toxic substance ingestion from the intial assessment and immediate resuscitation to specific antidotes and supportive therapies is described.
9
McKenzie, Alistair G. Historic timeline of obstetric anaesthesia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0001.
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Foremost in the history of obstetric anaesthesia was the introduction of inhalational analgesia by James Simpson in 1847, first with ether and then chloroform. Nitrous oxide was first used in obstetrics in 1880. Neuraxial anaesthesia in obstetrics began with spinal block by Oskar Kreis in 1900, and within 25 years included pudendal, caudal, and paracervical blocks. From 1902 there was a vogue for ‘twilight sleep’, which remained in use until the 1950s. Spinal anaesthesia only became popular with the advent of procaine in 1905; favour declined in the United Kingdom from 1948 and did not return until 40 years later. In 1930, Aburel described the pain pathways of labour. Continuous caudal analgesia for labour was popularized from 1942; it was superseded by the lumbar epidural approach in the 1960s. The arrival of lidocaine in 1950 was a major advance. Another important event in the 1960s was the elucidation of the supine hypotensive syndrome of late pregnancy. In the 1940s, intravenous barbiturates became popular. Mendelson published on the acid aspiration syndrome in 1946. It took 40 years to establish a reliable system of prevention, including fasting, antacids, and rapid sequence induction. This developed piecemeal, aided by recommendations from the British Confidential Enquiries into Maternal Deaths reports beginning in 1957. Neuraxial anaesthesia advanced: 24-hour epidural services (1960s), bupivacaine (1970s), epidural opioids (1980s), use of low-concentration bupivacaine with fentanyl mixtures, patient-controlled epidural and combined spinal–epidural analgesia (1990s), and pencil-point spinal needles (1990s). From the 1980s obstetric anaesthetists have assumed key roles in management of labour, preeclampsia/eclampsia, major haemorrhage, and perioperative care.
10
Griffiths, James, and Kate Drummond. Neurological disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0045.
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This chapter predominantly focuses on the provision of obstetric anaesthesia and analgesia for the parturient with neurological disease. Diseases of the central nervous system are an important cause of maternal morbidity and mortality. Maternal deaths may occur from such conditions as subarachnoid haemorrhage, intracerebral haemorrhage, thrombosis, and epilepsy. Neurological disease may impact on maternal well-being during pregnancy and pregnancy has the potential to exacerbate many neurological diseases. Many neurological conditions also have important implications for the safe conduct of neuraxial anaesthesia and analgesia, such as spina bifida and hydrocephalus. Management of these conditions may require care to be coordinated by a multidisciplinary team including the obstetrician, neurologist, neurosurgeon, and anaesthetist.
11
Medforth, Janet, Linda Ball, Angela Walker, Sue Battersby, and Sarah Stables. Maternal emergencies during pregnancy, labour, and postnatally. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198754787.003.0022.
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Maternal emergencies during pregnancy, labour, birth, and the postnatal period are covered. Blood tests during pregnancy and detecting deviations from the norm are included. Maternal emergencies and their management considered include: major obstetric haemorrhage, uterine rupture, eclampsia, emboli (pulmonary embolus and amniotic fluid embolus), HELLP syndrome, disseminated intravascular coagulation, uterine inversion, shock, and maternal resuscitation. Guidelines for admission to a high-dependency unit and current maternal morbidity and mortality data are included.
12
Medforth, Janet, Linda Ball, Angela Walker, Sue Battersby, and Sarah Stables. Pregnancy complications. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198754787.003.0012.
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The chapter is concerned with recognition and the most recent guidance on the management of commonly seen pregnancy complications. These include early pregnancy bleeding, antepartum haemorrhage, hyperemesis, obstetric cholestasis, multiple pregnancy, breech presentation, intrauterine growth restriction, thromboembolic disorders, and the principles of thromboprophylaxis. Each section describes the condition and factors that may lead to its development. Signs and symptoms are described, along with contraindications and aspects of treatment. Special considerations in the antenatal management plans are included.
13
Dutta, DK. Obstetrics Haemorrhage Made Easy. Jaypee Brothers Medical Publishers (P) Ltd., 2007. http://dx.doi.org/10.5005/jp/books/10565.
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Dutta, D. K. Obstetrics Haemorrhage Made Easy 2007. Jaypee Brothers Medical Publishers, 2008.
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15
Dragun, Duska, and Björn Hegner. Acute kidney injury in pregnancy. Edited by Norbert Lameire. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0250_update_001.
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Any kind of acute renal deterioration that occurs in young women may, besides typical pregnancy-related disorders, account for pregnancy-related acute kidney injury (PR-AKI). Incidence of PR-AKI is continuously decreasing, yet still represents a significant cause of fetomaternal morbidity and mortality. Hyperemesis gravidarum causing volume depletion and septic shock with renal cortical necrosis upon septic abortion are major causes of PR-AKI during early pregnancy. Pre-eclampsia and bleeding complications associated with placental abruption or other causes of obstetric haemorrhage are responsible for the majority of cases during late pregnancy (after week 35) and puerperium. Haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura disorders are less common than pre-eclampsia, yet represent a diagnostic and therapeutic challenge due to similar features to severe pre-eclampsia cases.
16
Barclay, Philip, and Helen Scholefield. High dependency and intensive care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0030.
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The development of maternal critical care is essential in reducing morbidity and mortality due to a substandard level of care. The level of critical care should depend upon the patient’s severity of illness, not their physical location. Escalation to level 3 (intensive) care is uncommon in pregnancy, with a median admission rate of 2.7 per 1000 births, mainly due to hypertensive disorders of pregnancy and haemorrhage. Maternal ‘near misses’ occur more frequently, with 6.5 per 1000 births meeting Mantel’s criteria, of which 85% is due to major obstetric haemorrhage. The admission rate to maternal high dependency units (level 2 care) varies from 1% to 5%. Acute physiological scoring systems have been found to be reliable when applied to parturients receiving level 3 care but overestimate mortality. Maternal early warning scores have been derived from simplified versions of these systems, with allowance made for physiological changes seen in pregnancy. There are many different maternity scoring systems in use throughout England and Wales. All share the same principle that parameters should be recorded regularly during the hospital stay, with deviations from normal quantified, recorded, and acted upon. A chain of response is then required to ensure that suitably qualified staff, possessing appropriate critical care competencies, attend in a timely fashion. Appropriate resources must be available with equipment readily to hand and suitably trained staff so that invasive monitoring can be used. Clear admission criteria are required for level 2 care within the delivery suite and escalation to level 3, with suitable arrangements for transfer.
17
Stacey, Victoria. Obstetrics and gynaecology. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199592777.003.0008.
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Abdominal pain in women - Ectopic pregnancy - Pelvic inflammatory disease (PID) - Other gynaecological causes of abdominal pain - Abnormal vaginal bleeding - Emergency contraception - Bleeding in pregnancy - Hyperemesis gravidarum - Pre-eclampsia and eclampsia - Rhesus prophylaxis—anti-D immunoglobulin - Emergency delivery - Postpartum haemorrhage - Pregnancy and trauma - SAQs
18
Doumouchtsis, Stergios K., S. Arulkumaran, Stergios K. Doumouchtsis, Anna Haestier, Edward Morris, Edward Prosser-Snelling, Kanchan Rege, Hannah Sims, and Eman Toeima. General issues in obstetrics and gynaecology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199651382.003.0020.
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This chapter outlines general issues in obstetrics and gynaecology. It describes haematological aspects of emergencies in obstetrics and gynaecology (thrombocytopenia, venous thromboembolism, pregnancy-induced exacerbations of pre-existing haematological conditions, and haemorrhage), the identification of very sick patients and options for monitoring, communication and handover between healthcare professionals, and preoperative assessment (risks, benefits, what to expect, and consent).
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Fox, Grenville, Nicholas Hoque, and Timothy Watts. Antenatal care, obstetrics, and fetal medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0001.
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This chapter contains details of methods used for screening and diagnosis of fetal anomalies using antenatal blood tests, ultrasound scanning, chorionic villous sampling, amniocentesis, and fetal blood sampling. There are sections on pre-existing maternal diseases presenting risks to the fetus including maternal diabetes, systemic lupus erythematosus, thrombocytopenia, and neuromuscular disease, as well as those specific to pregnancy—pre-eclampsia, HELLP syndrome, and eclampsia. Intrauterine growth restriction and monitoring is covered in detail. The increased fetal risks of multiple birth due to twin-to-twin transfusion syndrome and other pregnancy complications are described, with detail on oligohydramnios, polyhydramnios, antepartum haemorrhage, preterm prelabour rupture of membranes, cord prolapse, preterm labour, and breech presentation. Intrapartum fetal assessment using electronic fetal monitoring and fetal blood sampling to diagnose fetal distress is covered to enable health professionals involved in care of the newborn to understand events which may have resulted in a baby born in poor condition.