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Orthopedic Problems and Maternal Trauma

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Anesthetic and Obstetric Management of High-Risk Pregnancy

Summary

Parturients with musculoskeletal pathology as well as pregnant women as a trauma victim can be a complex problem to the anesthesiologists. Physiological changes during pregnancy should be taken into account while taking care of this patient. Close monitoring of both mother and fetus are essential for positive outcome.

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References

  1. Kristiansson P, Svardsudd K, Schoultz BV. Back pain during pregnancy: a prospective study. Spine 1996;21:702–709.

    Article  CAS  PubMed  Google Scholar 

  2. Rosaeg OP, Yarnell RW, Lindsay MP. The obstetrical anaesthesia assessment clinic: a review of six years experience. Can J Anaesth 1993; 40:346–356.

    CAS  PubMed  Google Scholar 

  3. Ostgaard HC, Andersson GBJ. Previous back pain and risk of developing back pain in a future pregnancy. Spine 1991;16:432–436.

    CAS  PubMed  Google Scholar 

  4. Orvieta R, Achiron A, Ben-Rafael Z, et al. Low back pain of pregnancy. Acta Obstet Gynecol Scand 1994;73:209–214.

    Google Scholar 

  5. Fast A, Shapiro D, Ducommun JD, et al. Low back pain in pregnancy. Spine 1987;12:368–371.

    CAS  PubMed  Google Scholar 

  6. Mantle MJ, Greenwood RM, Curry HLF. Backache in pregnancy. Rheumatol Rehabil 1977;16:95–101.

    Article  CAS  PubMed  Google Scholar 

  7. Ostgaard HC, Andersson GBJ. Postpartum low back pain. Spine 1992;17: 53–55.

    CAS  PubMed  Google Scholar 

  8. MacLennan AH, Nicolson R, Green RC. Serum relaxin in pregnancy. Lancet 1986;2:241–243.

    Article  CAS  PubMed  Google Scholar 

  9. MacLeod J, Macintyre C, McClure JH, et al. Backache and epidural analgesia. A retrospective survey of mothers 1 year after childbirth. Int J Obstet Anaesth 1995;4:21–25.

    Article  CAS  Google Scholar 

  10. MacArthur C, Lewis M, Knox EG, Crawford JS. Epidural anaesthesia and long term backache after childbirth. BMJ 1990;301:9–12.

    CAS  PubMed  Google Scholar 

  11. Breen TW, Ransil BJ, Groves PA, Oriol NE. Factors associated with back pain after childbirth. Anesthesiology 1994;81:29–34.

    CAS  PubMed  Google Scholar 

  12. Russell R, Dundas R, Reynolds F. Long term backache after childbirth: prospective search for causative factors. BMJ 1996;312:1384–1388.

    CAS  PubMed  Google Scholar 

  13. Chestnut DH. Obstetric Anesthesia. St. Louis: Mosby-Year Book, 1994.

    Google Scholar 

  14. Abram SE. Treatment of lumbosacral radiculopathy with epidural steroids. Anesthesiology 1999;91:1937–1941.

    Article  CAS  PubMed  Google Scholar 

  15. Bonica JJ. Bonica’s Management of Pain, 3rd edn. Philadelphia: Lippincott/Wiliams & Wilkins, 2001.

    Google Scholar 

  16. Jensen MC, Brant-Zawedzki MN, Obuchowski N, et al. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 1994;331:69–73.

    Article  CAS  PubMed  Google Scholar 

  17. LaBan MM, Perrin JC, Latimer FR. Pregnancy and the herniated lumbar disc. Arch Phys Med Rehabil 1983;64:319–321.

    CAS  PubMed  Google Scholar 

  18. Takahashi H, Suguro T, Okazima Y, et al. Inflammatory cytokines in the herniated disc of the lumbar spine. Spine 1996;21:218–24.

    Article  CAS  PubMed  Google Scholar 

  19. Hunt JL, Winkelstein BA, Rutkowski MD, et al. Repeated injury to the lumbar nerve roots produces enhanced mechanical allodynia and persistent spinal neuroinflammation. Spine 2001;26:2073–2079.

    Article  CAS  PubMed  Google Scholar 

  20. Winter RB. Adolescent idiopathic scoliosis. N Engl J Med 1986;314: 1379–1380.

    Article  CAS  PubMed  Google Scholar 

  21. Carter OD, Haynes SG. Prevalence rates for scoliosis in US adults: Results from the first National Health and Nutrition examination survey. Int J Epidemiol 1987;16:537–544.

    CAS  PubMed  Google Scholar 

  22. Hamilton PP, Byford LJ. Respiratory and cardiovascular functions in musculoskeloskeleal disorders. Probl Anesth 1991;5:91–106.

    Google Scholar 

  23. Kafer ER. Respiratory and cardiovascular functions in scoliosis and principles of anesthetic management. Anesthesiology 1980;52:339–351.

    CAS  PubMed  Google Scholar 

  24. Hirshfeld SS, Rudner C, Nash CL, et al. The incidence of mitral valve prolapse in adolescent scoliosis and thoracic hypokyphosis. Pediatrics 1982;70:451–454.

    Google Scholar 

  25. Lonstein JE, Carlson JM. The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg 1984;66A:1061–1071.

    Google Scholar 

  26. Bridwell KH. Surgical treatment of adolescent idiopathic scoliosis: the basics and controversies. Spine 1994;19:1095–1100.

    Article  CAS  PubMed  Google Scholar 

  27. Orvomaa E, Hiilesmaa V, Poussa M, et al. Pregnancy and delivery in patients operated by the Harrington method for idiopathic scoliosis. Eur Spine J 1997;6:304–307.

    Article  CAS  PubMed  Google Scholar 

  28. Harrington PR. Treatment of scoliosis: correction and internal fixation by spine instrumentation. J Bone Joint Surg 1962;44A:591–610.

    Google Scholar 

  29. Drummond D, Guadagni J, Keene JS, et al. Interspinous process segmental spinal instrumentation. J Pediatr Orthop 1984;4:397–404.

    CAS  PubMed  Google Scholar 

  30. Luque ER. Segmental spinal instrumentation for correction of scoliosis. Clin Orthop 1982;163:192–198.

    PubMed  Google Scholar 

  31. Crosby ET, Halpern SH. Obstetric epidural anaesthesia in patients with Harrington instrumentation. Can J Anaesth 1989;36:693–696.

    Article  CAS  PubMed  Google Scholar 

  32. Yeo ST, French R. Combined spinal-epidural in the obstetric patient with Harrington rods assisted by ultrasonography. Br J Anaesth 1999;83:670–672.

    CAS  PubMed  Google Scholar 

  33. Rayburn WF, Smith CV, Parriot JE, Woods RE. Randomised comparison of meperidine and fentanyl during labor. Obstet Gynecol 1989;74:604–606.

    CAS  PubMed  Google Scholar 

  34. Morrow MJ, Black IH. Epidural anaesthesia for caesarean section in an achondroplastic dwarf. Br J Anaesth 1998;81:619–621.

    CAS  PubMed  Google Scholar 

  35. Carstoniu J, Yee I, Halpern S. Epidural anaesthesia for caesarean section in an achondroplastic dwarf. Can J Anaesth 1992;39:708–711.

    Article  CAS  PubMed  Google Scholar 

  36. Brimacombe JR, Caunt JA. Anaesthesia in a gravid achondroplastic dwarf. Anaesthesia 1990;45:132–134.

    CAS  PubMed  Google Scholar 

  37. Ravenscroft A, Rout C. Epidural anaesthesia for caesarean section in an achondroplastic dwarf. Br J Anaesth 1999;82:301–303.

    CAS  PubMed  Google Scholar 

  38. Crawford M, Dutton DA. Spinal anaesthesia for caesarean section in an achondroplastic dwarf. Anaesthesia 1992;47:1007.

    CAS  PubMed  Google Scholar 

  39. Byers PH, Steiner RD. Osteogenesis imperfecta. Annu Rev Med 1992; 43:269–282.

    Article  CAS  PubMed  Google Scholar 

  40. Cole WG, Dalgleish R. Perinatal lethal osteogenesis imperfecta. J Med Genet 1995;32:284–289.

    CAS  PubMed  Google Scholar 

  41. Key TC, Horger EO. Osteogenesis imperfecta as a complication of pregnancy. Obstet Gynecol 1978;51:67–71.

    CAS  PubMed  Google Scholar 

  42. Evensen SA, Myhre L, Stormorken H. Haemostatic studies in osteogenesis imperfecta. Scand J Haematol 1984;33:177–179.

    Article  CAS  PubMed  Google Scholar 

  43. Hathaway W E, Solomons CC, Ott JE. Platelet function and pyrophosphates in osteogenesis imperfecta. Blood 1972;39:500–509.

    CAS  PubMed  Google Scholar 

  44. Cunningham AJ, Donnelly M, Comerford J. Osteogenesis imperfecta: anesthetic management of a patient for cesarean section: a case report. Anesthesiology 1984;61:91–93.

    CAS  PubMed  Google Scholar 

  45. Cho E, Dayan SS, Marx GF. Anaesthesia in a parturient with osteogenesis imperfecta. Br J Anaesth 1992;68:422–423.

    CAS  PubMed  Google Scholar 

  46. Broome IJ. Spinal anaesthesia for Caesarean section in a patient with spina bifida cystica. Anaesth Intensive Care 1989;17:377–379.

    CAS  PubMed  Google Scholar 

  47. McGrady EM, Davis AG. Spina bifida occulta and epidural anaesthesia. Anaesthesia 1988;43:867–869.

    CAS  PubMed  Google Scholar 

  48. Vaagenes P, Fjaerestad I. Epidural block during labour in a patient with spina bifida cystica. Anaesthesia 1981;36:299–301.

    CAS  PubMed  Google Scholar 

  49. Nuyten F, Gielen M. Spinal catheter anaesthesia for caesarean section in a patient with spina bifida. Anaesthesia 1990;45:846–847.

    CAS  PubMed  Google Scholar 

  50. Ong BY, Graham CR, Ringaert KRA, et al. Impaired epidural analgesia after dural puncture with and without subsequent blood patch. Anesth Analg 1990;70:76–79.

    CAS  PubMed  Google Scholar 

  51. DiGiovanni AJ, Galbert MW, Wahle WM. Epidural injection of autologous blood for postlumbar-puncture headache. II. Additional clinical experiences and laboratory investigation. Anesth Analg 1972;51:226–232.

    CAS  PubMed  Google Scholar 

  52. Hebl JR, Horlocker TT, Chantigian RC, Schroeder DR. Epidural anesthesia and analgesia are not impaired after dural puncture with or without epidural blood patch. Anesth Analg 1999;89:390–394.

    Article  CAS  PubMed  Google Scholar 

  53. Stone IK. Trauma in the obstetric patient. Obstet Gynecol Clin North Am 1999;26:459–467, viii.

    Article  CAS  PubMed  Google Scholar 

  54. Vaizey CJ, Jaconson MJ, Cross FW. Trauma in pregnancy. Br J Surg 1994;81:1406–1415.

    CAS  PubMed  Google Scholar 

  55. Henderson SO, Mallon WK. Trauma in pregnancy. Emerg Med Clin N Am 1998;16:209–228.

    Article  CAS  Google Scholar 

  56. Pearlman MD, Tintinalli JE. Evaluation and treatment of the gravida and fetus following trauma during pregnancy. Obstet Gynecol Clin N Am 1991;18:371–381.

    CAS  Google Scholar 

  57. Pearlman MD, Tintinalli JE, Lorenz RP. A prospective controlled study of outcome after trauma in pregnancy. Am J Obstet Gynecol 1990;162: 1502–1507.

    CAS  PubMed  Google Scholar 

  58. Ueland K, Novy MJ, Peterson EN, Metcalfe J. Maternal cardiovascular dynamics. IV. The influence of gestational age on the maternal cardiovascular response to posture and exercise. Am J Obstet Gynecol 1969;104:856–864.

    CAS  PubMed  Google Scholar 

  59. Sachs BP, Brown DA, Driscoll SG, et al. Maternal mortality in Massachusetts. Trends and prevention. N Engl J Med 1987;316:667–672.

    Article  CAS  PubMed  Google Scholar 

  60. Fildes J, Reed L, Jones N, et al. Trauma: the leading cause of maternal death. J Trauma 1992;32:643–645.

    CAS  PubMed  Google Scholar 

  61. Lavin JP, Polsky SS. Abdominal trauma during pregnancy. Clin Perinatol 1983;10:423–438.

    PubMed  Google Scholar 

  62. Report on Confidential Enquiries into Maternal Deaths in the United Kingdom, 1988–1990. London: HSMO, 1994.

    Google Scholar 

  63. Bochicchio GV, Napolitano LM, Haan J, et al. Incidental pregnancy in trauma patients. J Am Coll Surg 2001;192:566–569.

    Article  CAS  PubMed  Google Scholar 

  64. Connolly AM, Katz VL, Bash KL, et al. Trauma and pregnancy. Am J Perinatol 1997;14:331–336.

    Article  CAS  PubMed  Google Scholar 

  65. Goldman SM, Wagner LK. Radiologic management of abdominal trauma in pregnancy. Am J Radiol 1996;166:763–767.

    CAS  Google Scholar 

  66. Hill DA, Lense JJ. Abdominal trauma in the pregnant patient. Am Fam Physician 1996;53:1269–1274.

    CAS  PubMed  Google Scholar 

  67. Lavery JP, Staten-McCormick M. Management of moderate to severe trauma in pregnancy. Obstet Gynecol Clin N Am 1995;22:69–90.

    CAS  Google Scholar 

  68. Scorpio RJ, Esposito TJ, Smith LG, Gens DR. Blunt trauma during pregnancy: factors affecting fetal outcome. J Trauma 1992;32:213–216.

    CAS  PubMed  Google Scholar 

  69. Ali J, Yeo A, Gana TJ, McLellan B. Predictors of fetal mortality in pregnant trauma patients. J Trauma 1997;42:782–785.

    CAS  PubMed  Google Scholar 

  70. Weiss HB, Songer TJ, Fabio A. Fetal deaths related to maternal injury. JAMA 2001;286:1863–1868.

    Article  CAS  PubMed  Google Scholar 

  71. Rogers FB, Rozycki GS, Osler TM, et al. A multi-institutional study of factors associated with fetal death in injured pregnant patients. Arch Surg 1999;134:1274–1277.

    Article  CAS  PubMed  Google Scholar 

  72. Domeier RM, O’Conner RE, Delbridge TR, et al. Position Paper: Use of pneumatic anti-shock garment (PASG). National Association of EMS Physicians, 1997:33–35.

    Google Scholar 

  73. Moore MM, Shearer DR. Fetal dose estimates for CT pelvimetry. Radiology 1989;171:265–267.

    CAS  PubMed  Google Scholar 

  74. Harrison SD, Nghiem HV, Shy K. Uterine rupture with fetal death following blunt trauma. Am J Radiol 1995;165:1452.

    CAS  Google Scholar 

  75. Goodwin H, Holmes JF, Wisner DH. Abdominal ultrasound examination in pregnant blunt trauma patients. J Trauma 2001;50:689–693.

    CAS  PubMed  Google Scholar 

  76. Schiff M, Kasnic T, Reiff K, Pathak D. Seatbelt use during pregnancy. West J Med 1992;156:665–667.

    Google Scholar 

  77. Chang A, Magwene K, Frand E. Increased safety belt use following education in childbirth classes. Birth 1987;14:148–152.

    CAS  PubMed  Google Scholar 

  78. Pearlman MD, Viano D. Automobile crash simulation with the first pregnant crash test dummy. Am J Obstet Gynecol 1996;175:977–981.

    CAS  PubMed  Google Scholar 

  79. Crosby WM, King AL, Stout LC. Fetal survival following impact: improvement with shoulder harness restraint. Am J Obstet Gynecol 1972; 112:1101–1106.

    CAS  PubMed  Google Scholar 

  80. Feliciano DV, Burch JM, Spjut-Patrinely V, et al. Abdominal gunshot wounds: An urban trauma center’s experience with 300 consecutive patients. Ann Surg 1988;208:362–370.

    CAS  PubMed  Google Scholar 

  81. Awwad JT, Azar GB, Seoud MA, et al. High-velocity penetrating wounds of the gravid uterus: review of 16 years of civil war. Obstet Gynecol 1994;83:259–264.

    CAS  PubMed  Google Scholar 

  82. Rose PG, Strohm PL, Zuspan FP. Fetomaternal hemorrhage following trauma. Am J Obstet Gynecol 1985;153:844–847.

    CAS  PubMed  Google Scholar 

  83. Emery CL, Morway LF, Chung-Park M, et al. The Kleihauer-Betke test. Clinical utility, indication, and correlation in patients with placental abruption and cocaine use. Arch Pathol Lab Med 1995;119:1032–1037.

    CAS  PubMed  Google Scholar 

  84. Towery R, English TP, Wisner D. Evaluation of pregnant women after blunt injury. J Trauma 1993;35:731–735.

    CAS  PubMed  Google Scholar 

  85. Jordan BD. Maternal head trauma during pregnancy. Adv Neurol 1994; 64:131–138.

    CAS  PubMed  Google Scholar 

  86. Feldmman DM, Borgida AF, Rodis JF, Campbell WA. Irreversible maternal brain injury during pregnancy. A case report and review of the literature. Obstet Gynecol Surv 2000;55:708–714.

    Article  Google Scholar 

  87. Polko LE, McMahon MJ. Burns in pregnancy. Obstet Gynecol Surv 1998; 53:50–56.

    Article  CAS  PubMed  Google Scholar 

  88. Mabrouk AR, E l-Feky AE. Burns during pregnancy: a gloomy outcome. Burns 1997;23:596–600.

    Article  CAS  PubMed  Google Scholar 

  89. Matthews RN. Obstetric implications of burns in pregnancy. Br J Obstet Gynaecol 1982;89:603–609.

    CAS  PubMed  Google Scholar 

  90. Amy BW, McManus WF, Goodwin CW, et al. Thermal injury in the pregnant patient. Surg Gynecol Obstet 1985;161:209–212.

    CAS  PubMed  Google Scholar 

  91. Esposito TJ. Trauma during pregnancy. Emerg Med Clin N Am 1994;12: 167–199.

    CAS  Google Scholar 

  92. Rothenberger DA, Quattlebaum FW, Zabel J, Fischer RP. Diagnostic peritoneal lavage for blunt trauma in pregnant women. Am J Obstet Gynecol 1977;102:752–769.

    Google Scholar 

  93. Trauma during pregnancy. Technical bulletin no. 161. ACOG, 1991.

    Google Scholar 

  94. Grubb DK. Nonsurgical management of penetrating uterine trauma in pregnancy: a case report. Am J Obstet Gynecol 1992;166:583–584.

    CAS  PubMed  Google Scholar 

  95. Dahmus MA, Sibai BM. Blunt abdominal trauma: are there any predictive factors for abruptio placentae or maternal-fetal distress? Am J Ob-stet Gynecol 1993;169:1054–1059.

    CAS  Google Scholar 

  96. Curet MJ, Schermer CR, Demarest GB, et al. Predictors of outcome in trauma during pregnancy: identification of patients who can be monitored for less than 6 hours. J Trauma 2000;49:18–24.

    Article  CAS  PubMed  Google Scholar 

  97. Dildy GA, Clark SL. Cardiac arrest during pregnancy. Obstet Gynecol Clin N Am 1995;22:303–314.

    CAS  Google Scholar 

  98. Katz VL, Dotters DJ, Droegemueller W. Perimortem cesarean delivery. Obstet Gynecol 1986;68:571–576.

    CAS  PubMed  Google Scholar 

  99. Marx GF. Cardiopulmonary resuscitation of late pregnant women. Anesthesiology 1982;56:156.

    CAS  PubMed  Google Scholar 

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Authors
  1. John P.R. Loughrey
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  2. Mehmet R. Genç
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Editor information

Editors and Affiliations

  1. Harvard Medical School, USA

    Sanjay Datta MD, FFARCS(ENG) (Professor Anesthesia and Director of Obstetric Anesthesia) & David L. Hepner MD (Assistant Professor of Anesthesia and Assistant Director) (Professor Anesthesia and Director of Obstetric Anesthesia) &  (Assistant Professor of Anesthesia and Assistant Director)

  2. Brigham and Women’s Hospital, Boston, Massachusetts, 20115, USA

    Sanjay Datta MD, FFARCS(ENG) (Professor Anesthesia and Director of Obstetric Anesthesia) (Professor Anesthesia and Director of Obstetric Anesthesia)

  3. Preadmitting Test Center, Brigham and Women’s Hospital, Boston, Massachusetts, 20115, USA

    David L. Hepner MD (Assistant Professor of Anesthesia and Assistant Director) (Assistant Professor of Anesthesia and Assistant Director)

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Loughrey, J.P., Genç, M.R. (2004). Orthopedic Problems and Maternal Trauma. In: Datta, S., Hepner, D.L. (eds) Anesthetic and Obstetric Management of High-Risk Pregnancy. Springer, New York, NY. https://doi.org/10.1007/0-387-21572-7_15

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  • DOI: https://doi.org/10.1007/0-387-21572-7_15

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-00443-3

  • Online ISBN: 978-0-387-21572-3

  • eBook Packages: Springer Book Archive

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