bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Chloroprocaine Versus Lidocaine With Epinephrine, Sodium Bicarbonate, and Fentanyl for Epidural Extension Anesthesia in Elective Cesarean Delivery: A Randomized, Triple-blind, Noninferiority Study
Authors: Sharawi N. , Bansal P. , Williams M. , Spender H. , Mhyre J. 
Published: September 2022

(Anesth Analg. 2021;132: 666–675)
Neuraxial analgesia is utilized in over 70% of labors in the United States. The authors of this study report a general consensus among their local and nonlocal peers that 3% chloroprocaine or CP, a local anesthetic with a quick preparation time, and 2% lidocaine, epinephrine, bicarbonate, and fentanyl, or LEBF, which needs additional preparation time, have similar onset times when used to convert epidural pain relief to epidural anesthesia for cesarean delivery (CD). To their knowledge, no study has confirmed this assumption. This study analyzes the onset times of CP and LEBF.
Effectiveness of Uterine Tamponade Devices for Refractory Postpartum Hemorrhage After Vaginal Birth: A Systematic Review
Authors: Pingray V. , Widmer M. , Ciapponi A. , Hofmeyr G.J. , Deneux C. , Gülmezoglu M. , Bloemenkamp K. , Oladapo O.T. , Comandé D. , Bardach A. , Vázquez P. , Cormick G. , Althabe F. 
Published: September 2022

(BJOG. 2021;128:1732–1743)
Most postpartum hemorrhage (PPH) deaths occur due to uterine atony. While first-line interventions for PPH such as uterotonics, tranexamic acid, and uterine massage are effective for most patients, 10% to 20% of patients are unresponsive to these and are deemed to have “refractory” PPH. Uterine tamponade devices (UTD) used to treat refractory PPH include uterine balloon tamponade (UBT) and uterine suction tamponade (UST). The World Health Organization has previously issued a conditional recommendation for the use of UBT to treat refractory PPH due to uterine atony, based on case series and studies with no control population. Since then, several relevant studies, including randomized controlled trials, have been published. This systematic review aims to evaluate uterine tamponade devices for safety and effectiveness in treating atonic refractory PPH following vaginal birth and examine the effects of including uterine tamponade devices into institutional PPH protocols.
Preincision Adjunctive Prophylaxis for Cesarean Deliveries: A Systematic Review and Meta-analysis
Authors: Markwei M.T. , Babatunde I. , Rathi N. , Fan C. , Prah M.-A. , Joo J. , Hackett L. , Soper D.E. , Goje O. 
Published: September 2022

(Am J Obstet Gynecol. 2021;225:382.e1–382.e13)
Surgical site infections (SSI) occur after 2% to 7% of cesarean deliveries. While the administration of preincision beta-lactam antibiotics is recommended, there is a high rate of SSIs following cesarean delivery. Adjunctive prophylaxis, or the administration of a second antibiotic, has been shown to decrease postcesarean SSI rates. Azithromycin has been the adjunctive prophylaxis drug of choice in addition to cefazolin. As azithromycin was more difficult to obtain during the COVID-19 pandemic, clarithromycin has been used in its place. This study aimed to evaluate the use of preincision cefazolin with macrolides or metronidazole compared with cefazolin alone in terms of decreasing the incidence of SSIs following cesarean delivery.
Spontaneous Intracranial Hypotension
Authors: Schievink W.I. 
Published: September 2022

(N Engl J Med. 2021;385:2173–2178)
Spontaneous intracranial hypotension presents as below-normal cerebrospinal fluid (CSF) due to CSF leakage from an unknown cause. While spontaneous intracranial hypotension is treatable, it is difficult to diagnose. Imaging has identified 3 types of spontaneous spinal CSF leaks: linear tear in the dura posterolateral or ventral to the spinal cord; diffuse dilatations of the dural sac or leakage at the simple meningeal diverticula; or the space between the CSF-venous fistulas and proximal veins. It is estimated that spontaneous intracranial hypotension occurs in 4 to 5 cases per 100,000 population.
Turn Your Attention to Distractions
Authors: Rothman B.S. , Bledsoe S. , Rice M.J. 
Published: September 2022

(Anesth Analg. 2022;134:266–268)
The use of personal electronic devices (PEDs) in health care can support effective communication, enhance patient safety and contribute to higher quality of care. PEDs allow providers to document care in electronic medical records, communicate securely, and leverage applications for situational awareness. They can also be used to support medical education and direction, as well as care team models, regardless of location.
Adverse Pregnancy Outcomes Attributable to Socioeconomic and Ethnic Inequalities in England: A National Cohort Study
Authors: Jardine J. , Walker K. , Gurol-Urganci I. , Webster K. , Muller P. , Hawdon J. , Khalil A. , Harris T. , van der Meulen J. ,   on behalf of the National Maternity and Perinatal Audit Project Team
Published: September 2022

(Lancet. 2021;398:1905–1912)
Pregnancy outcomes (eg, stillbirth, preterm birth, and neonatal and infant mortality) in high-income countries tend to be worse among patients from ethnic minority groups and lower socioeconomic status (SES) compared with White patients or patients of higher SES. While there are efforts to reduce these inequalities, more information is needed to understand which groups are most affected and how severe these gaps are. This national cohort study examined the socioeconomic and ethnic inequalities in the rates of fetal growth restriction (FGR), preterm birth, and stillbirth, accounting for health conditions at the beginning of pregnancy and complications that affect pregnancy.
Association of Medicaid Expansion With Neuraxial Labor Analgesia Use in the United States: A Retrospective Cross-Sectional Analysis
Authors: Xiao M. , Whitney D. , Guo N. , Sun E. , Wong C. , Bentley J. , Butwick A. 
Published: September 2022

(Anesth Analg. 2022;134:505–514)
Before 2010, 1 in 4 women and 1 in 8 pregnant women were uninsured. The United States’ Patient Protection and Affordable Care Act enacted in 2010 aimed to insure these uninsured individuals and families by increasing Medicaid coverage. The number of states observing this act, as it is optional, has increased from 26 in 2014 to 38 in 2021. While Medicaid expansion increased coverage for prenatal care and childhood, Medicaid’s effect on neuraxial labor analgesia use is unclear. Previous studies show lower pain scores, and higher patient satisfaction scores are linked with neuraxial analgesia for the 75% of women who receive it. Localized labor analgesia minimizes general anesthesia risks, including airway complications, postoperative pain, and neonatal resuscitation. This study analyzes the effects of Medicaid expansion on neuraxial labor analgesia use since its adoption.
Trends, Characteristics, and Outcomes of Placenta Accreta Spectrum: A National Study in the United States
Authors: Matsuzaki S. , Mandelbaum R.S. , Sangara R.N. , McCarthy L.E. , Vestal N.L. , Klar M. , Matsushima K. , Amaya R. , Ouzounian J.G. , Matsuo K. 
Published: September 2022

(Am J Obstet Gynecol. 2021;225:534.e1–534.e38)
Placenta accreta spectrum (PAS) is a rare but dangerous condition that occurs when placental tissue attaches into the gravid uterus, specified by degrees of invasive attachment. Maternal death is among the risks of this condition in the peri-cesarean delivery (CD) period. Other reports on PAS draw from a small number of patients or are limited to a single hospital. A large national survey was performed to investigate population-wide prevalence, risks, characteristics, and outcomes for patients with PAS in the context of CD.
Attention-deficit/Hyperactivity Disorder in Children Following Prenatal Exposure to Antidepressants: Results From the Norwegian Mother, Father, and Child Cohort Study
Authors: Lupattelli A. , Mahic M. , Handal M. , Ystrom E. , Reichborn-Kjennerud T. , Nordeng H. 
Published: September 2022

(BJOG. 2021;128:1917–1927. [Epub June 8, 2021])
Previous investigations into the risk of offspring developing attention-deficit/hyperactivity disorder (ADHD) due to prenatal exposure to antidepressants have produced inconsistent conclusions. While familial factors have been identified as the most important influence for increased ADHD risk in children exposed at any point prenatally to antidepressants, it is unknown if timing or duration of exposure increase risk. This study measured the association of child ADHD by diagnoses and symptoms with prenatal use of selective serotonin (SSRI) and serotonin-norepinephrine (SNRI) reuptake inhibitor antidepressants at any time during pregnancy, or by timing and duration. Quantification bias of exposure misclassification was handled by study replication in an exposure-controlled subgroup.
Temporal Trends in Between and Within-country Inequalities in Cesarean Delivery in Low- and Middle-income Countries: A Bayesian Analysis
Authors: Hasan M.M. , Ahmed S. , Soares Magalhaes R.J. , Begum T. , Fatima Y. , Mamun A.A. 
Published: September 2022

(BJOG. 2021;128:1928–1937. [Epub June 1, 2021])
Cesarean delivery (CD) is recognized as an important life-saving intervention that also carries adverse risks. Following the dramatic rise in CD globally, health organizations have provided recommendations for avoiding preventable CD. Previous analysis of trends in CD coverage have examined global, regional, and national-level rates, but exclude other socioeconomic analysis. Low- and middle-income countries (LMIC) are the focus of this study with the intention of identifying groups vulnerable to avoidable CD and strategies to prevent these cases.
Characterizing the Need for Multiple Epidural Blood Patches in the Treatment of Postdural Puncture Headache: An Observational Study
Authors: Mustafa R. , Barman R. , Kurian E. , Eldrige J. , Frank R. , Kissoon N. , Garza I. , Whealy M. , Cutsforth-Gregory J. , Olatoye O. 
Published: September 2022

(Reg Anesth Pain Med. 2021;46:1110–1112)
Previous studies have determined the effectiveness of epidural blood patch (EBP) on postdural puncture headache (PDPH) patients, though little research has been done on repeated image guided EBP. This study aims to predict the factors contributing to and the rate of repeated image-guided EBP treatment for (PDPH) patients.
Introduction of a Standardized Maternity Early Warning System: Indicative Data From a Before-and-After Study at a Large Pilot Site Before National Rollout in Aotearoa New Zealand
Authors: Drake M. , Austin G. , Dann L. , Li Y. , Shuker C. , Psirides A. 
Published: September 2022

(Anaesthesia. 2021;76:1600–1606)
While there are recognition and response standards in place to decrease preventable adverse outcomes for nonpregnant adult patients and there is maternity-specific observation scoring system (MEOWS) in place for obstetric patients in the United Kingdom. An in-depth multidisciplinary review of study cases in Aotearoa New Zealand showed inadequate recognition and response standards may have significantly impacted maternal morbidity. A major tertiary hospital in Auckland piloted a modified version of the Aotearoa New Zealand early warning system (NZEWS) to promote better recognition and response of deteriorating pregnant women (NZMEWS). This study aimed to determine the efficacy of NZMEWS shown in the number of code blue and code red (cardiorespiratory arrests and very unwell women need an emergency response team, respectively) comparing the occurrence of codes before and after NZMEWS implementation.
Unanticipated Consequences of Switching to Sugammadex: Anesthesia Provider Survey on the Hormone Contraceptive Drug Interaction
Authors: Dwan R.L. , Raymond B.L. , Richardson M.G. 
Published: September 2022

(Anesth Analg. 2021;133:958–966)
Sugammadex is thought to reduce the efficacy of hormonal contraceptive (HC) due to its ability to bind progesterone. In February 2017, a large, tertiary-care medical center switched from neostigmine to sugammadex as the neuromuscular blockade (NMB) drug of choice. Care should be taken by anesthesiologists to recommend alternative contraceptive methods for patients exposed to sugammadex to avoid unintentional pregnancy. This study, conducted 2 years following the switch to sugammadex, aims to assess the institution’s anesthesiologist provider management of the drug and any knowledge gaps present.
Spontaneous Abortion Following COVID-19 Vaccination During Pregnancy
Authors: Kharbanda E.O. , Haapala J. , DeSilva M. , Vazquez-Benitez G. , Vesco K.K. , Naleway A.L. , Lipkind H.S. 
Published: September 2022

(JAMA. 2021;326:1629–1631)
Spontaneous abortion is one of the most important outcomes of interest for COVID-19 vaccine studies in the pregnant population. At the time of publication of this study, 1 vaccine was approved and 2 were authorized for use in pregnant women. Data on maternal COVID-19 safety was primarily collected through passive surveillance. This study used data collected from case-control surveillance of pregnant women COVID-19 and vaccination data from electronic health records, with spontaneous abortion as the main outcome.
Covid-19 Vaccination During Pregnancy and First-trimester Miscarriage
Authors: Magnus M.C. , Gjessing H.K. , Eide H.N. , Wilcox A.J. , Fell D.B. , Håberg S.E. 
Published: September 2022

(N Engl J Med. 2021;385:2008–2010. [Epub October 20, 2021])
Parturient women are encouraged to receive the COVID-19 vaccination to decrease adverse maternal outcomes, however, vaccination safety data during pregnancy is limited.
A Randomized Pilot Clinical Trial of Pravastatin Versus Placebo in Pregnant Patients at High Risk of Preeclampsia
Authors: Constantine M.M. , West H. , Wisner K.L. , Caritis S. , Clark S. , Venkataramanan R. , Stika C.S. , Rytting E. , Wang X. , Ahmed M.S. 
Published: September 2022

(Am J Obstet Gynecol. 2021;225:666.e1–15)
Preeclampsia affects up to 8% of pregnancies and is associated with maternal and neonatal morbidities. Preeclampsia also shares characteristics with other cardiovascular diseases. Pravastatin has been considered a possible method of preventing preeclampsia, supported by preclinical studies and pilot clinical studies using 10 mg pravastatin in high-risk patients. This study aimed to determine the safety and pharmacokinetic parameters of 20 mg pravastatin in patients with a high risk of preeclampsia.
Use of Metformin to Prolong Gestation in Preterm Preeclampsia
Authors: Cluver C.A. , Hiscock R. , Decloedt E.H. , Hall D.R. , Schell S. , Mol B.W. , Brownfoot F. , Kaitu'u-Lino T.J. , Walker S.P. , Tong S. 
Published: September 2022

(BMJ. 2021;374:n2103)
Preterm preeclampsia affects 10% of all women with preeclampsia worldwide. Although preeclampsia prevention is attempted with therapies including low-dose aspirin, there are no current treatments for preeclampsia once diagnosed other than delivery. Preterm preeclampsia causes increased risk for both maternal and neonatal morbidity and mortality, especially in developing areas without adequate obstetric or NICU care.
Addition of Oral Iron Bisglycinate to Intravenous Iron Sucrose for the Treatment of Postpartum Anemia-randomized Controlled Trial
Authors: Yefet E. , Mruat Rabah S. , Sela N.D. , Hosary Mhamed S. , Yossef A. , Nachum Z. 
Published: September 2022

(Am J Obstet Gynecol. 2021;225:668.e1–668.e9. [Epub June 23, 2021])
Postpartum anemia has serious adverse maternal outcomes. Iron is the primary cause of postpartum anemia. Moderate to severe anemia is recommended to be treated with intravenous (IV) iron such as iron sucrose. Although IV iron has been found to be superior to oral treatment for rate of serum ferritin and hemoglobin (Hb) increase, compliance after discharge may be low due to need for use of medical facilities for administration. Adding oral to IV iron has not been evaluated. This study aimed to determine whether oral iron bisglycinate added to IV iron sucrose for the treatment of postpartum anemia was more effective than IV iron sucrose.
Effect of Minimally Invasive Surfactant Therapy Versus Sham Treatment on Death or Bronchopulmonary Dysplasia in Preterm Infants With Respiratory Distress Syndrome The OPTIMIST: A Randomized Clinical Trial
Authors: Dargaville P.A. , Kamlin O.F. , Orsini F. , Wang X. , De Paoli A.G. , Kanmaz Kutman H.G. , Cetinkaya M. , Aiyappan A. , Lemyre B. , Kuo S. , Rajadurai V.S. , O’Shea J. , Biniwale M. , Ramanathan R. , Kushnir A. , Bader D. , Thomas M.R. , Mallinath C. , Buksh M.J. , Bhatia R. , Sullivan C.L. , Shinwell E.S. , Dyson A. , Barker D.P. , Kugelman A. , Donovan T.J. , Tauscher M.K. , Murthy V. , Ali S.K.M. , Yossuck P. , Clark H.W. , Soll R.F. , Carlin J.B. , Davis P.G. 
Published: September 2022

(JAMA. 2021;326:2478–2487)
Continuous positive airway pressure (CPAP) is recommended for newly born preterm infants. A previous meta-analysis of clinical trials compared CPAP to intubation and ventilation in terms of death or bronchopulmonary dysplasia and found CPAP had a relative risk of 0.91 [95% confidence interval (CI), 0.84-0.99]. In the studies used in meta-analysis, exogenous surfactant was administered only to infants with relatively high levels of inspired oxygen. This study, the OPTIMIST-A trial aimed to determine whether minimally invasive surfactant therapy, using a thin catheter, would lower the incidence of death and/or bronchopulmonary dysplasia.
Hydrocortisone to Improve Survival Without Bronchopulmonary Dysplasia
Authors: Watterberg K.L. , Walsh M.C. , Li L. , Chawla S. , D'Angio C.T. , Goldberg R.N. , Hintz S.R. , Laughon M.M. , Yoder B.A. , Kennedy K.A. , McDavid G.E. , Backstrom-Lacy C. , Das A. , Crawford M.M. , Keszler M. , Sokol G.M. , Poindexter B.B. , Ambalavanan N. , Hibbs A.M. , Truog W.E. , Schmidt B. , Wyckoff M.H. , Khan A.M. , Garg M. , Chess P.R. , Reynolds A.M. , Moallem M. , Bell E.F. , Meyer L.R. , Patel R.M. , Van Meurs K.P. , Cotten C.M. , McGowan E.C. , Hines A.C. , Merhar S. , Peralta-Carcelen M. , Wilson-Costello D.E. , Kilbride H.W. , DeMauro S.B. , Heyne R.J. , Mosquera R.A. , Natarajan G. , Purdy I.B. , Lowe J.R. , Maitre N.L. , Harmon H.M. , Hogden L.A. , Adams-Chapman I. , Winter S. , Malcolm W.F. , Higgins R.D. ,   Eunice Kennedy Shriver NICHD Neonatal Research Network
Published: September 2022

(N Engl J Med. 2022;386:1121–1131)
The diagnosis of bronchopulmonary dysplasia (BPD) in extremely preterm infants portends potentially abnormal growth, neurodevelopment, and respiratory function. This prevalent condition affects half of extreme preterm birth survivors and likely has a multiplicity of causes: prematurity, oxygen exposure, mechanical ventilation, and inflammatory processes. Dexamethasone was previously widely used until adverse neurological effects including cerebral palsy and cognitive impairment became apparent in the patient population later in life. Despite these complications, many extremely premature infants continue to receive dexamethasone therapy for BPD. Hydrocortisone, another steroid, when administered to extremely premature neonates has produced advantageous characteristics and has shown promising test results in neonates who are developing BPD. Administration of hydrocortisone showed mitigating effects on neonatal inflammation and decreased adverse neurodevelopmental effects. This extended trial, beginning in 2011, investigates the efficacy of high-dose hydrocortisone treatment at improving life expectancy without BPD by monitoring for severe neurodevelopmental disorder through 22 to 26 months.
Safety of Nirsevimab for RSV in Infants With Heart or Lung Disease or Prematurity
Authors: Domachowske J. , Madhi S.A. , Simões E.A.F. , Atanasova  ,   the MEDLEY Study Group
Published: September 2022

(N Engl J Med. 2022;386:892–894)
Nirsevimab (N) is a monoclonal antibody with an extended half-life and enhanced potency at inhibiting respiratory syncytial virus (RSV) in cell-culture and animal models over the existing drug palivizumab (Pa). The results from the first RSV season of a study spanning 2 seasons on the safety and pharmacokinetics of N are reported. Otherwise healthy late-term and term infants infected with RSV were assessed in MELODY phase 2B and phase 3 trials, while a separate ongoing study is evaluating the efficacy of N in infants at risk for severe RSV infection.
Women With Kidney Disease Can Be Given a Personal Risk Assessment for Pregnancy
Authors: Saul H. , Gursul D. 
Published: September 2022

(BMJ. 2021;375:n2526)
Advanced chronic kidney disease (CKD) is associated with a higher risk of preterm birth and low birthweight neonates. Studies exploring maternal and neonatal complications associated with CKD have been scarce. A large recent study examined predictive factors for the risk of complications and progression of kidney disease during pregnancy among patients with CKD.
Intrathecal Catheter Use After Accidental Dural Puncture in Obstetric Patients: Literature Review and Clinical Management Recommendations
Authors: Orbach-Zinger S. , Jadon A. , Lucas D. N. , Sia A. T. , Tsen L. C. , Van de Velde M. , Heesen M. 
Published: September 2022

(Anaesthesia. 2021;76:1111–1121)
In the event of an accidental dural puncture (ADP) the epidural can be either resited or a catheter can be inserted intrathecally for use as a continuous spinal (intrathecal, IT) catheter, thus eliminating the need for needle reinsertion. An IT catheter may also permit swift labor analgesia and facilitate cesarean delivery anesthesia. However, clinical management of IT catheters for labor analgesia is not without risk of adverse effects. Accordingly, this review evaluates recent studies on IT catheters for parturients, including the management and quality of analgesia and anesthesia, the effect on postdural puncture headache (PDPH) risk, obstacles to use, and deficiencies in our current understanding.
The Association Between Labor Epidural Case Volume and the Rate of Accidental Dural Puncture
Authors: Sidhu N.S. , Cavadino A. , Ku H. , Kerckhoffs P. , Lowe M. 
Published: September 2022

(Anaesthesia. 2021;76:1060–1067)
Labor analgesia accomplished with epidural catheter placement can be complicated by accidental dural puncture (ADP), with recent reported rates at obstetric centers ranging from 0.52% to 3.6%. The incidence of postdural puncture headache following ADP is frequent and can be severe and debilitating. The assumption that ADP rate is higher among trainees compared with specialists has opposing data in the literature, which analysis may have been confounded by a factor of skill decay. This study examined the effect of decreased labor epidural volume and skill decay on ADP rate and the effect of training grade among anesthesia trainees on likelihood of ADP.
Factors Associated With an Increased Risk of Instrumental Vaginal Delivery in Women With Epidural Analgesia for Labor: A Retrospective Cohort Study
Authors: Au-Yong P.S. , Tan C.W. , Tan W.H. , Tan K.H. , Goh Z. , Sultana R. , Sng B.L. 
Published: September 2022

(Eur J Anaesthesiol. 2021;38:1059–1066)
Although epidural analgesia is an effective and common method of pain management during labor and delivery, studies suggest there may be an increased risk of instrumental vaginal delivery (IVD, forceps or vacuum extractor) use. Instrumental delivery increases risk of maternal and neonatal morbidity and outcomes. This study aimed to identify women at increased risk of instrumental delivery and strategies to decrease associated maternal and neonatal morbidity.