Pre-eclampsia through the eyes of the obstetrician and anesthesiologist

Siddiqui, Maryam; Banayan, Jennifer M.; Hofer, Jennifer

doi:10.1016/j.ijoa.2019.04.002

Cited by 7 publications

(8 citation statements)

References 66 publications

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“…inadecuada. Esto conduce a hipoxia y liberación de especies reactivas de oxígeno, que acentúan el estrés oxidativo y la disfunción placentaria (12). Todo esto induce inflamación con liberación de quimiocinas, citocinas proinflamatorias, factores antiangiogénicos y activación de monocitos/neutrófilos (13).…”

Section: Discussionunclassified

“…Todo esto induce inflamación con liberación de quimiocinas, citocinas proinflamatorias, factores antiangiogénicos y activación de monocitos/neutrófilos (13). La segunda etapa comienza cuando los neutrófilos activados infiltran el tejido vascular materno, produciendo inflamación sistémica materna con activación plaquetaria, vasoconstricción, hipertensión, disfunción endotelial e isquemia de órganos terminales (12)(13)(14). Por otra parte, existe un cambio hacia un estado proinflamatorio, con mayor alteración de la respuesta inmune (1,13).…”

Section: Discussionunclassified

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Utilidad diagnóstica de la relación plaquetas/linfocitos en embarazadas con preeclampsia

Mejia-Montilla¹,

Reyna-Villasmil²,

Torres-Cepeda³

et al. 2021

RSOGV

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Objective: To establish the diagnostic utility of the platelet-lymphocyte ratio in pregnant women with preeclampsia. Methods: A case-control study was carried out at the Hospital Central “Dr. Urquinaona” Maracaibo, Venezuela. A total of 180 pregnant women were selected. Ninety preeclamptic women were included as the study group (group A) and a control group selected for their age and body mass index similar to the study group, which consisted of 90 healthy normotensive pregnant women (group B). The general characteristics, platelet-lymphocyte ratio values and diagnostic efficacy were determined. Results: Group A patients presented lower platelet and lymphocyte values compared to group B patients (p <0.001). However, no statistically significant differences were found in platelet-lymphocyte ratio between group A patients (115.2 ± 32.7) and group B patients (122.3 ± 23.8; p = 0, 0971). A cut-off value of the platelets-lymphocyte ratio of 117 presented a value below the curve of 0.57, the sensitivity of 47.8%, the specificity of 50.0%, the positive predictive value of 48.9%, and the negative predictive value of 52.2%, with a diagnostic accuracy of 48.9%. Conclusion: Platelet-lymphocyte ratio is not a useful tool in the diagnosis of preeclampsia, since patients with the syndrome present similar values to normotensive pregnant women. Keywords: Platelet-lymphocyte ratio, Preeclampsia, Diagnosis, Pregnancy.

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Section: Discussionunclassified

Utilidad diagnóstica de la relación plaquetas/linfocitos en embarazadas con preeclampsia

Mejia-Montilla¹,

Reyna-Villasmil²,

Torres-Cepeda³

et al. 2021

RSOGV

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“…Women with pre-eclampsia are susceptible to hypertensive emergencies, increasing the risk of intracranial haemorrhage and other serious maternal complications such as heart failure [73]. Systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 110 mmHg on two separate occasions at least 4 h apart is a feature of severe pre-eclampsia [74].…”

Section: Hypertensive Crisismentioning

confidence: 99%

Emergencies in obstetric anaesthesia: a narrative review

2022

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We conducted a narrative review in six areas of obstetric emergencies: category-1 caesarean section; difficult and failed airway; massive obstetric haemorrhage; hypertensive crisis; emergencies related to neuraxial anaesthesia; and maternal cardiac arrest. These areas represent significant research published within the last five years, with emphasis on large multicentre randomised trials, national or international practice guidelines and recommendations from major professional societies. Key topics discussed: prevention and management of failed neuraxial technique; role of high-flow nasal oxygenation and choice of neuromuscular drug in obstetric patients; prevention of accidental awareness during general anaesthesia; management of the difficult and failed obstetric airway; current perspectives on the use of tranexamic acid, fibrinogen concentrate and cell salvage; guidance on neuraxial placement in a thrombocytopenic obstetric patient; management of neuraxial drug errors, local anaesthetic systemic toxicity and unusually prolonged neuraxial block regression; and extracorporeal membrane oxygenation use in maternal cardiac arrest.

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“…The use of magnesium requires monitoring for potential toxicity, which includes observation of urine output, vital signs and respiratory rate, as well as response of the patellar reflex and surveillance of the serum magnesium levels, which physiologically range from 4-7 mEq/l (30). Magnesium toxicity, which can occur in cases of elevated magnesium levels is another indication of admission to CCUs, and dialysis to clear magnesium may be required (31). For critically ill patients with preeclampsia conditions, fluid management serves a key role.…”

Section: Non-obstetric Indicationsmentioning

confidence: 99%

Role of Critical Care Units in the management of obstetric patients (Review)

et al. 2021

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Pregnancy is considered a natural process for the majority of women. However, a limited proportion of pregnancies and deliveries can present with a broad variety of complications that may require admission to a Critical Care Unit (CCU). In the present review, the indications of admission of obstetrical and postpartum patients to CCUs were critically evaluated with a particular focus on the management of their complications. The management of critically ill obstetric patients remains challenging due to the physiological changes that occur during pregnancy, pregnancy-related diseases and the need to carefully consider the well-being of the fetus before any intervention can be recommended/performed. Indications for admission to CCUs include both obstetric and non-obstetric conditions that may require continuous monitoring and further interventions. Hypertensive disorders of pregnancy and mass hemorrhage are amongst the most common causes of admission to CCUs in pregnant and postpartum women. The establishment of a diagnostic and care algorithm based on the contribution of a multidisciplinary team is of critical importance to aid in the determination of which patients will require intensive care, and to assist in deciding what type of critical care each critically ill patients receives.

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Pre-eclampsia through the eyes of the obstetrician and anesthesiologist

Cited by 7 publications

References 66 publications

Utilidad diagnóstica de la relación plaquetas/linfocitos en embarazadas con preeclampsia

Utilidad diagnóstica de la relación plaquetas/linfocitos en embarazadas con preeclampsia

Emergencies in obstetric anaesthesia: a narrative review

Role of Critical Care Units in the management of obstetric patients (Review)

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