Obstetric Anesthesiology Research
Advancing Obstetric and Perinatal Anesthetic Care
Research Mission Statement
To advance knowledge in the field of obstetric anesthesiology and peripartum care through clinical, epidemiological, and outcomes-based research.
Research Vision Statement
To optimize and personalize maternal care provided by obstetric anesthesiologists.
Our Research Faculty
Our faculty are internationally recognized experts in obstetric anesthesiology.
We aim to advance the health and well-being of mothers by:
- Ensuring each woman obtains high-quality pain relief during and after her delivery.
- Identifying approaches for preventing and treating postpartum hemorrhage.
- Expanding knowledge related to women’s recovery after delivery.
How our research has changed practice
Research from our group has been instrumental in advancing maternal and peripartum care. Through our research, we have developed new protocols and approaches for preventing and managing postpartum hemorrhage, enhanced methods to manage mothers’ pain during labor and after cesarean delivery, improved knowledge of how drugs behave in the peripartum setting, and designed instruments to measure recovery after childbirth.
Our faculty have gained recognition for their outstanding contributions to innovation and knowledge in peripartum care and obstetric anesthesiology. Our work has received funding support from the National Institute for Health, Stanford Maternal & Child Health Research Institute and industry partners. Our research has been recognized with the receipt of numerous scientific awards from several international medical societies.
At the Society of Obstetric Anesthesiology and Perinatology annual scientific meetings, the most prestigious obstetric anesthesia meeting in the world, we have won the Best Scientific Paper award on 3 occasions, and been a finalist for this award on 7 occasions. Our trainee-mentored research has been consistently recognized with an unprecedented 13 Resident/Fellow Research Presentation awards in the past 18 years. We have also received scientific meeting research awards from the American Society of Anesthesiology, Obstetric Anaesthetists’ Association of Great Britain, and the Canadian Anesthesiologists' Society.
Our work has been published in high-impact scientific journals on numerous occasions (see all publications). We have produced and contributed towards several national guidelines and consensus statements produced by the Society of Obstetric Anesthesiology and Perinatology, the American Heart Association and the World Health Organization.
Our obstetric anesthesia facility was the first in the nation to be designated as a Society for Obstetric Anesthesia and Perinatology Center of Excellence, and Brendan Carvalho was appointed as President of the Society for Obstetric Anesthesia and Perinatology between 2017 and 2018.
Integrated trajectories of the maternal metabolome, proteome, and immunome predict labor onset.
Science translational medicine
Stelzer, I. A., Ghaemi, M. S., Han, X., Ando, K., Hedou, J. J., Feyaerts, D., Peterson, L. S., Rumer, K. K., Tsai, E. S., Ganio, E. A., Gaudilliere, D. K., Tsai, A. S., Choisy, B., Gaigne, L. P., Verdonk, F., Jacobsen, D., Gavasso, S., Traber, G. M., Ellenberger, M., Stanley, N., Becker, M., Culos, A., Fallahzadeh, R., Wong, R. J., Darmstadt, G. L., Druzin, M. L., Winn, V. D., Gibbs, R. S., Ling, X. B., Sylvester, K., Carvalho, B., Snyder, M. P., Shaw, G. M., Stevenson, D. K., Contrepois, K., Angst, M. S., Aghaeepour, N., Gaudilliere, B.
2021; 13 (592)
Estimating the time of delivery is of high clinical importance because pre- and postterm deviations are associated with complications for the mother and her offspring. However, current estimations are inaccurate. As pregnancy progresses toward labor, major transitions occur in fetomaternal immune, metabolic, and endocrine systems that culminate in birth. The comprehensive characterization of maternal biology that precedes labor is key to understanding these physiological transitions and identifying predictive biomarkers of delivery. Here, a longitudinal study was conducted in 63 women who went into labor spontaneously. More than 7000 plasma analytes and peripheral immune cell responses were analyzed using untargeted mass spectrometry, aptamer-based proteomic technology, and single-cell mass cytometry in serial blood samples collected during the last 100 days of pregnancy. The high-dimensional dataset was integrated into a multiomic model that predicted the time to spontaneous labor [R = 0.85, 95% confidence interval (CI) [0.79 to 0.89], P = 1.2 * 10-40, N = 53, training set; R = 0.81, 95% CI [0.61 to 0.91], P = 3.9 * 10-7, N = 10, independent test set]. Coordinated alterations in maternal metabolome, proteome, and immunome marked a molecular shift from pregnancy maintenance to prelabor biology 2 to 4 weeks before delivery. A surge in steroid hormone metabolites and interleukin-1 receptor type 4 that preceded labor coincided with a switch from immune activation to regulation of inflammatory responses. Our study lays the groundwork for developing blood-based methods for predicting the day of labor, anchored in mechanisms shared in preterm and term pregnancies.
View details for DOI 10.1126/scitranslmed.abd9898
View details for PubMedID 33952678
Intravenous oxytocin dosing regimens for postpartum hemorrhage prevention at cesarean section: a systematic review and meta-analysis.
American journal of obstetrics and gynecology
Phung, L. C., Farrington, E. K., Connolly, M., Wilson, A. N., Carvalho, B., Homer, C. S., Vogel, J. P.
OBJECTIVE: To synthesize available evidence on intravenous (IV) oxytocin dosing regimens for the prevention of postpartum hemorrhage (PPH) at cesarean section (CS).DATA SOURCES: We searched Medline/OVID, Embase, Global Index Medicus, CINAHL, CENTRAL, ClinicalTrials.gov, and ICTRP for eligible studies published until Feb 2020.STUDY ELIGIBILITY CRITERIA: We included any randomized or non-randomized study published in peer-reviewed journals that compared at least two different dosing regimens of IV oxytocin for PPH prevention in women undergoing CS.STUDY APPRAISAL AND SYNTHESIS METHODS: Two authors independently assessed eligibility, extracted data, and assessed risk of bias. Primary outcome was incidence of PPH ≥ 1000 mL. Other review outcomes included use of additional uterotonics, blood loss, and adverse maternal events. Data were analyzed based on type of IV administration (bolus only, infusion only, bolus plus infusion) and oxytocin dose. Meta-analysis was performed using randomized trials and reported using risk ratios or mean difference with 95% confidence intervals. GRADE was used to rate the certainty of evidence. Findings from dose-finding trials and non-randomized studies were reported narratively.RESULTS: Thirty-five studies (7,333 women) met our inclusion criteria, including 30 randomized trials and five non-randomized studies. There were limited data from trials for most outcomes, and results were not conclusive. Compared to bolus plus infusion regimens, bolus only regimens probably result in slightly higher mean blood loss (MD 52 mL, 95% CI 0.4-104 mL, moderate certainty). Amongst bolus plus infusion regimens, initial bolus doses < 5 IU may reduce nausea (RR 0.26, 95% CI 0.11-0.63, low certainty) as compared to 5-9 IU. Total oxytocin doses 5-9 IU versus 10-19 IU may increase use of additional uterotonics (RR 13.00, 95% CI 1.75-96.37, low certainty). Effects on other outcomes were generally inconclusive.CONCLUSION: There are limited data comparing IV oxytocin regimens for PPH prevention at CS. Bolus plus infusion regimens may lead to minor reductions in mean blood loss, and initial bolus doses of < 5 IU may minimize nausea. Bolus only regimens of 10 IU versus 5 IU may decrease use of additional uterotonics, however further comparative trials are required to understand effects on other key outcomes, particularly hypotension.
View details for DOI 10.1016/j.ajog.2021.04.258
View details for PubMedID 33957113
An observational pilot study of a novel loss of resistance syringe for locating the epidural space.
International journal of obstetric anesthesia
Athar, M. W., Guo, N., Ortner, C., Carvalho, B., Abir, G., Riley, E. T.
BACKGROUND: The EpiFaith syringe is a novel loss-of-resistance syringe that utilizes a spring-loaded plunger that automatically moves forward within the syringe when there is a loss of resistance. We evaluated the syringe in a clinical setting, among a cohort of pregnant women receiving neuraxial labor analgesia.METHODS: In a non-randomized, observational study, four anesthesiologists used the EpiFaith syringe 10 times each while placing epidural catheters for labor analgesia. The anesthesiologists scored each placement on an 11-point Likert scale (-5 = absolutely worse, 0 = the same, and 5 = absolutely better than using their regular loss-of-resistance syringe technique).RESULTS: All 40 neuraxial placements correctly located the epidural space. Air was used in the syringe in 35 of the 40 cases. In 50%, 27.5% and 22.5% of cases the anesthesiologists reported that using the EpiFaith syringe was better than, the same as, or worse than using their regular syringe, respectively. There were no inadvertent dural punctures.CONCLUSIONS: This feasibility study found that three of the four anesthesiologists scored the EpiFaith syringe as better or the same as using their regular loss-of-resistance syringe. More extensive studies are required to determine if the EpiFaith syringe reduces adverse outcomes such as unintentional dural punctures.
View details for DOI 10.1016/j.ijoa.2021.102984
View details for PubMedID 33994273
Superficial Cervical Plexus Block for Awake Large-Bore Central Line Placement in Parturients: A Case Series.
Sheikh, M., Carvalho, B., Boublik, J., Ansari, J.
2021; 15 (3): e01429
Pregnant patients with high-risk conditions including abnormal placentation or severe cardiovascular disease may require large-bore central venous access at the time of delivery. Central lines are generally inserted while obstetric patients are awake, either because neuraxial anesthesia is planned or to minimize fetal exposure to anesthetic medications. Despite local infiltration, the procedure can cause significant patient discomfort. This case series describes use of a superficial cervical plexus block (SCPB) to facilitate line placement in 4 pregnant women with high-risk conditions. SCPB is technically straightforward with low reported complication rates and should be considered for pregnant patients requiring large-bore central lines.
View details for DOI 10.1213/XAA.0000000000001429
View details for PubMedID 33740791
Point-of-Care Lung Ultrasound Pattern in Healthy Parturients: Prevalence of Pulmonary Interstitial Syndrome Following Vaginal Delivery, Elective and Unplanned Intrapartum Cesarean Delivery.
Anesthesia and analgesia
Macias, P. n., Wilson, J. G., Austin, N. S., Guo, N. n., Carvalho, B. n., Ortner, C. M.
Pregnancy-related cardiovascular physiologic changes increase the likelihood of pulmonary edema, with the risk of fluid extravasating into the pulmonary interstitium being potentially at a maximum during the early postpartum period. Data on the impact of labor and peripartum hemodynamic strain on lung ultrasound (LUS) are limited, and the prevalence of subclinical pulmonary interstitial syndrome in peripartum women is poorly described. The primary aim of this exploratory study was to estimate the prevalence of pulmonary interstitial syndrome in healthy term parturients undergoing vaginal (VD), elective (eCD), and unplanned intrapartum cesarean deliveries (uCD). Secondary aims were to estimate the prevalence of positive lung regions (≥3 B-lines on LUS per region) and to assess the associations between positive lung regions and possible contributing factors.In this prospective observational cohort study, healthy women at term undergoing VD, eCD, or uCD were enrolled. Following international consensus recommendations, a LUS examination was performed within 4 hours after delivery applying an 8-region technique. Pulmonary interstitial syndrome was defined by the presence of 2 or more positive lung regions per hemithorax. Ultrasound studies were reviewed by 2 blinded reviewers and assessed for interobserver reliability.Seventy-five women were assessed (n = 25 per group). No pulmonary interstitial syndrome was found in the VD and eCD groups (each 0 of 25; 0%, 95% confidence interval [CI], 0-13.7). Pulmonary interstitial syndrome was found in 2 of 25 (8%, 95% CI, 1-26) women undergoing an uCD (P = .490 for VD versus uCD and P = .490 for eCD versus uCD). In 1 woman, this correlated clinically with the development of pulmonary edema. One or more positive lung regions were present in 5 of 25 (20%), 6 of 25 (24%), and 11 of 25 (44%) parturients following VD, eCD, and uCD, respectively (P = .136). Positive lung regions were predominantly found in lateral lung regions. The number of positive lung regions showed a weak correlation with patient age (r = 0.25, 95% CI, 0.05-0.47; P = .033). No significant association was found between LUS pattern and parity, duration of labor, labor augmentation, labor induction, estimated total intravenous fluid intake, or net intravenous fluid intake.Although many focal areas of increased extravascular lung water (20%-44% prevalence) can be identified on LUS, the overall prevalence of pulmonary interstitial syndrome was 2.7% (2 of 75; 95% CI, 0.3-9.3) among healthy term parturients soon after delivery. Focal areas of positive lung water regions were weakly correlated with maternal age.
View details for DOI 10.1213/ANE.0000000000005464
View details for PubMedID 33721873
Genetics and Gender in Acute Pain and Perioperative Opioid Analgesia.
Kwon, A. H., Flood, P.
2020; 38 (2): 341–55
Experimental and clinical acute pain research in relation to biological sex and genetics started in the 1980s. Research methods became more powerful and sensitive with the advancement in affordable gene sequencing methods and high-throughput genetic assays. Decades of research has identified several potential pharmaceutical targets, providing insights into future research direction, and understanding of acute pain and opioid analgesic effects in the clinical setting. However, there is insufficient evidence to make generalized recommendations for using genetic tests for clinical practice of acute pain management.
View details for DOI 10.1016/j.anclin.2020.01.003
View details for PubMedID 32336388
Impact of patient choice for different postcesarean delivery analgesic protocols on opioid consumption: a randomized prospective clinical trial.
Regional anesthesia and pain medicine
Carvalho, B., Sutton, C. D., Kowalczyk, J. J., Flood, P. D.
BACKGROUND: Choice of postcesarean delivery analgesic protocol may improve pain experience and reduce analgesic requirements.METHODS: Cesarean delivery patients were randomly assigned either to choose their postcesarean delivery analgesia protocol or to have no choice and receive routine care. Choices were low (50 mug intrathecal morphine), medium (identical to routine care: 150 mug intrathecal morphine), or high (300 mug intrathecal morphine with 600mg oral gabapentin). All groups received scheduled acetaminophen and ibuprofen. The primary outcome was oxycodone requirements 0-48hours postdelivery in those offered versus not offered a choice.RESULTS: Of 160 women enrolled, 120 were offered a choice and 40 were not offered a choice. There was no difference in oxycodone requirements or pain associated with choice, but those who had a choice expressed more satisfaction than those who did not have a choice (mean (95%CI) difference 5% (0% to 10 %), p=0.005). In the choice group, the high dose group required more oxycodone (5 (0 to 15)mg 0-24hours after delivery and 15 (10 to 25) mg at 24-48hours; p=0.05 and p=0.001) versus the low and medium groups. The low dose group had less pruritus (p=0.001), while the high dose group had more vomiting (p=0.01) requiring antiemetic treatment (p=0.04).CONCLUSION: Having a choice compared with no choice routine care did not reduce oxycodone requirements or pain scores. However, women have insight into their analgesic needs; women offered a choice and who chose the higher dose analgesic protocol required more oxycodone, and women who chose the lower dose protocol required less oxycodone. Despite providing additional analgesic (six times more intrathecal morphine plus gabapentin in high dose vs low dose protocols), we still did not equalize postcesarean oxycodone requirement differences between groups.TRIAL REGISTRATION NUMBER: NCT02605187.
View details for PubMedID 30867278
Comparative Effectiveness of Cognitive Behavioral Therapy for Chronic Pain and Chronic Pain Self-Management within the Context of Voluntary Patient-Centered Prescription Opioid Tapering: The EMPOWER Study Protocol.
Pain medicine (Malden, Mass.)
Darnall, B. D., Mackey, S. C., Lorig, K. n., Kao, M. C., Mardian, A. n., Stieg, R. n., Porter, J. n., DeBruyne, K. n., Murphy, J. n., Perez, L. n., Okvat, H. n., Tian, L. n., Flood, P. n., McGovern, M. n., Colloca, L. n., King, H. n., Van Dorsten, B. n., Pun, T. n., Cheung, M. n.
Evidence to date, while sparse, suggests that patients taking long-term opioids require special considerations and protections to prevent potential iatrogenic harms from opioid de-prescribing, such as increased pain or suffering. Following this study protocol, the EMPOWER study seeks to address multiple unmet needs of patients with chronic pain who desire to reduce long-term opioid therapy, and provide the clinical evidence on effective methodology.EMPOWER applies patient-centered methods for voluntary prescription opioid reduction conducted within a comprehensive, multi-state, 3-arm randomized controlled comparative effectiveness study of three study arms (1) group cognitive behavioral therapy for chronic pain; (2) group chronic pain self-management; and (3) usual care (taper only). Specialized electronic data capture systems collect patient reported symptoms and satisfaction data weekly and monthly during the taper, with real-time clinical alerts and electronic feedback loops informing, documenting, and steering needed care actions.The EMPOWER study seeks to provide granular evidence on patient response to voluntary opioid tapering, and will provide evidence to inform clinical systems changes, clinical care, patient satisfaction, and patient outcomes for opioid reduction.
View details for DOI 10.1093/pm/pnz285
View details for PubMedID 31876947
Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU
CRITICAL CARE MEDICINE
Devlin, J. W., Skrobik, Y., Gelinas, C., Needham, D. M., Slooter, A. C., Pandharipande, P. P., Watson, P. L., Weinhouse, G. L., Nunnally, M. E., Rochwerg, B., Balas, M. C., van den Boogaard, M., Bosma, K. J., Brummel, N. E., Chanques, G., Denehy, L., Drouot, X., Fraser, G. L., Harris, J. E., Joffe, A. M., Kho, M. E., Kress, J. P., Lanphere, J. A., McKinley, S., Neufeld, K. J., Pisani, M. A., Payen, J., Pun, B. T., Puntillo, K. A., Riker, R. R., Robinson, B. H., Shehabi, Y., Szumita, P. M., Winkelman, C., Centofanti, J. E., Price, C., Nikayin, S., Misak, C. J., Flood, P. D., Kiedrowski, K., Alhazzani, W.
2018; 46 (9): E825–E873
To update and expand the 2013 Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the ICU.Thirty-two international experts, four methodologists, and four critical illness survivors met virtually at least monthly. All section groups gathered face-to-face at annual Society of Critical Care Medicine congresses; virtual connections included those unable to attend. A formal conflict of interest policy was developed a priori and enforced throughout the process. Teleconferences and electronic discussions among subgroups and whole panel were part of the guidelines' development. A general content review was completed face-to-face by all panel members in January 2017.Content experts, methodologists, and ICU survivors were represented in each of the five sections of the guidelines: Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption). Each section created Population, Intervention, Comparison, and Outcome, and nonactionable, descriptive questions based on perceived clinical relevance. The guideline group then voted their ranking, and patients prioritized their importance. For each Population, Intervention, Comparison, and Outcome question, sections searched the best available evidence, determined its quality, and formulated recommendations as "strong," "conditional," or "good" practice statements based on Grading of Recommendations Assessment, Development and Evaluation principles. In addition, evidence gaps and clinical caveats were explicitly identified.The Pain, Agitation/Sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) panel issued 37 recommendations (three strong and 34 conditional), two good practice statements, and 32 ungraded, nonactionable statements. Three questions from the patient-centered prioritized question list remained without recommendation.We found substantial agreement among a large, interdisciplinary cohort of international experts regarding evidence supporting recommendations, and the remaining literature gaps in the assessment, prevention, and treatment of Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) in critically ill adults. Highlighting this evidence and the research needs will improve Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) management and provide the foundation for improved outcomes and science in this vulnerable population.
View details for PubMedID 30113379
Patient-Centered Prescription Opioid Tapering in Community Outpatients with Chronic Pain
JAMA Internal Medicine
Darnall, B., Ziadni, M., Stieg, R., Mackey, I., Kao, M., Flood, P.
2018; Feb 19
View details for DOI 10.1001/jamainternmed.2017.8709
Association of Gestational Age with Postpartum Hemorrhage: An International Cohort Study
Butwick, A. J., Liu, C., Guo, N., Bentley, J., Main, E. K., Mayo, J. A., Shaw, G. M., Stephansson, O.
2021; 134 (6): 874-886
Risk factors for postpartum hemorrhage, such as chorioamnionitis and multiple gestation, have been identified in previous epidemiologic studies. However, existing data describing the association between gestational age at delivery and postpartum hemorrhage are conflicting. The aim of this study was to assess the association between gestational age at delivery and postpartum hemorrhage.The authors conducted a population-based retrospective cohort study of women who underwent live birth delivery in Sweden between 2014 and 2017 and in California between 2011 and 2015. The primary exposure was gestational age at delivery. The primary outcome was postpartum hemorrhage, classified using International Classification of Diseases, Ninth Revision-Clinical Modification codes for California births and a blood loss greater than 1,000 ml for Swedish births. The authors accounted for demographic and obstetric factors as potential confounders in the analyses.The incidences of postpartum hemorrhage in Sweden (23,323/328,729; 7.1%) and in California (66,583/2,079,637; 3.2%) were not comparable. In Sweden and California, the incidence of postpartum hemorrhage was highest for deliveries between 41 and 42 weeks' gestation (7,186/75,539 [9.5%] and 8,921/160,267 [5.6%], respectively). Compared to deliveries between 37 and 38 weeks, deliveries between 41 and 42 weeks had the highest adjusted odds of postpartum hemorrhage (1.62 [95% CI, 1.56 to 1.69] in Sweden and 2.04 [95% CI, 1.98 to 2.09] in California). In both cohorts, the authors observed a nonlinear (J-shaped) association between gestational age and postpartum hemorrhage risk, with 39 weeks as the nadir. In the sensitivity analyses, similar findings were observed among cesarean deliveries only, when postpartum hemorrhage was classified only by International Classification of Diseases, Tenth Revision-Clinical Modification codes, and after excluding women with abnormal placentation disorders.The postpartum hemorrhage incidence in Sweden and California was not comparable. When assessing a woman's risk for postpartum hemorrhage, clinicians should be aware of the heightened odds in women who deliver between 41 and 42 weeks' gestation.
View details for DOI 10.1097/ALN.0000000000003730
View details for Web of Science ID 000648691100012
View details for PubMedID 33760074
Association of Epidural Labor Analgesia With Offspring Risk of Autism Spectrum Disorders.
Wall-Wieler, E., Bateman, B. T., Hanlon-Dearman, A., Roos, L. L., Butwick, A. J.
Importance: Epidural labor analgesia (ELA) has been associated with an increased offspring risk of autism spectrum disorder (ASD). Whether this finding may be explained by residual confounding remains unclear.Objective: To assess the association between ELA and offspring risk of ASD.Design, Setting, and Participants: Longitudinal cohort study of vaginal deliveries of singleton live infants born from 2005 to 2016 from a population-based data set linking information from health care databases in Manitoba, Canada; offspring were followed from birth until 2019 or censored by death or emigration. Data were analyzed from October 19, 2020, to January 22, 2021.Exposures: Epidural labor analgesia.Main Outcomes and Measures: At least 1 inpatient or outpatient diagnosis of ASD in offspring aged at least 18 months. For the full population and a sibling cohort, inverse probability of treatment-weighted Cox proportional hazards regression analyses were used to control for potential confounders.Results: Of the 123 175 offspring included in this study (62 647 boys [50.9%]; mean [SD] age of mothers, 28.2 [5.8] years), 47 011 (38.2%) were exposed to ELA; 2.1% (985 of 47 011) of exposed vs 1.7% (1272 of 76 164) of unexposed offspring were diagnosed with ASD in the follow-up period (hazard ratio [HR], 1.25; 95% CI, 1.15-1.36). After adjusting for maternal sociodemographic, prepregnancy, pregnancy, and perinatal covariates, ELA was not associated with an offspring risk of ASD (inverse probability of treatment-weighted HR, 1.08; 95% CI, 0.97-1.20). In the within-siblings design adjusting for baseline covariates, ELA was not associated with ASD (inverse probability of treatment-weighted HR, 0.97; 95% CI, 0.78-1.22). Results from sensitivity analyses restricted to women without missing data who delivered at or after 37 weeks of gestation, firstborn infants only, and offspring with ASD classified with at least 2 diagnostic codes were consistent with findings from the main analyses.Conclusions and Relevance: In a Canadian population-based birth cohort study, no association between ELA exposure and an increased offspring risk of ASD was found.
View details for DOI 10.1001/jamapediatrics.2021.0376
View details for PubMedID 33871547
Antepartum and postpartum anemia: a narrative review.
International journal of obstetric anesthesia
Butwick, A. J., McDonnell, N.
Antepartum anemia impacts over a third of pregnant women globally and is associated with major maternal and perinatal morbidity, including peripartum transfusion, maternal death, maternal infection, preterm birth, and neurodevelopmental disorders among offspring. Postpartum anemia impacts up to 80% of women in low-income and rural populations and up to 50% of women in Europe and the United States, and is associated with postpartum depression, fatigue, impaired cognition, and altered maternal-infant bonding. Iron deficiency is the most common cause of maternal anemia because of insufficient maternal iron stores at the start of pregnancy, increased pregnancy-related iron requirements, and iron losses due to blood loss during parturition. Anemic women should undergo testing for iron deficiency; a serum ferritin cutoff level of 30 mug/L is commonly used to diagnose iron deficiency during pregnancy. The first-line treatment of iron deficiency is oral iron. Intravenous iron is a consideration in the following scenarios: a poor or absent response to oral iron, severe anemia (a hemoglobin concentration <80 g/L), rapid treatment for anemia in the third trimester, women at high risk for major bleeding (such as those with placenta accreta), and women for whom red blood cell transfusion is not an option. Given the high prevalence of antepartum and postpartum anemia, anesthesiologists are advised to partner with other maternal health professionals to develop anemia screening and treatment pathways.
View details for DOI 10.1016/j.ijoa.2021.102985
View details for PubMedID 33893005
Risk Factors for Postpartum Readmission Among Women After Having a Stillbirth.
American journal of obstetrics & gynecology MFM
DiTosto, J. D., Liu, C., Wall-Wieler, E., Gibbs, R. S., Girsen, A. I., El-Sayed, Y. Y., Butwick, A. J., Carmichael, S. L.
BACKGROUND: Compared to women with a livebirth, women with a stillbirth are more likely to have maternal complications during pregnancy and at birth, but risk factors related to their postpartum health are uncertain.OBJECTIVE: This study aimed to identify patient-level risk factors for postpartum hospital readmission among women after having a stillbirth.STUDY DESIGN: This is a population-based cohort study of 29,654 women with a stillbirth in California from 1997-2011. Using logistic regression models, we examined the association of maternal patient-level factors with postpartum readmission among women after a stillbirth within six weeks of hospital discharge and between six weeks and nine months after birth.RESULTS: Within six weeks after a stillbirth, 642 (2.2%) women had a postpartum readmission. Risk factors for postpartum readmission after a stillbirth were: severe maternal morbidity excluding transfusion (aOR= 3.02, 95% CI 2.28-4.00), transfusion at delivery but no other indication of severe maternal morbidity (aOR= 1.95, 95% CI 1.35-2.81), gestational hypertension or preeclampsia (aOR=1.93, 95% CI 1.54-2.42), pre-pregnancy hypertension (aOR= 1.80, 95% CI 1.36-2.37), diabetes (aOR= 1.78, 95% CI = 1.33-2.37), an antenatal hospitalization (aOR= 1.78, 95% CI 1.43-2.21), cesarean birth (aOR= 1.73, 95% CI 1.43-2.21), long (> 2 days for vaginal birth, > 4 days for cesarean birth) birth hospitalization length of stay (aOR= 1.59, 95% CI 1.33-1.89), non- Hispanic black race/ ethnicity (aOR= 1.38, 95% CI 1.08-1.76), and having less than a high school education (aOR= 1.35, 95% CI 1.02-1.80). From 6 weeks to 9 months, 1,169 (3.90%) women had a postpartum readmission; significantly associated risk factors were largely similar to those for earlier readmission.CONCLUSION: Women with comorbidities, birth-related complications, of non-Hispanic black race/ ethnicity, or with less education had increased odds of postpartum readmission after having a stillbirth, highlighting the importance of continued care for these women after birth hospitalization.TRIAL REGISTRATION: Not applicable.
View details for DOI 10.1016/j.ajogmf.2021.100345
View details for PubMedID 33705999
Positive predictive value of ICD-10 codes for placenta accreta syndrome: a single center validation study
Jotwani, A. R., Leonard, S. A., Butwick, A., Lyell, D. J.
MOSBY-ELSEVIER. 2021: S523–S524
View details for Web of Science ID 000621547401386
A systematic review of patient-reported outcome measures used to assess sleep in postpartum women using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.
Sultan, P. n., Ando, K. n., Sultan, E. n., Hawkins, J. n., Blake, L. n., Barwick, F. n., Kawai, M. n., Carvalho, B. n.
We performed a systematic review to identify the best patient-reported outcome measure (PROM) of postpartum sleep in women.We searched 4 databases for validated PROMs used to assess postpartum sleep. Studies were considered if they evaluated at least 1 psychometric measurement property of a PROM. An overall rating was assigned for each psychometric measurement property of each PROM based upon COSMIN criteria. A modified GRADE approach was used to assess the level of evidence and recommendations were then made for each PROM.We identified 15 validation studies of 8 PROMs, in 9,070 postpartum women. An adequate number of sleep domains was assessed by 5 PROMs: Bergen Insomnia Scale (BIS), Pittsburgh Sleep Quality Index (PSQI), General Sleep Disturbance Scale (GSDS), Athens Insomnia Scale (AIS) and the Sleep Symptom Checklist (SSC). BIS and GSDS were the only PROMs to demonstrate adequate content validity and at least a low level of evidence of sufficient internal consistency, resulting in Class A recommendations. The BIS was the only PROM, which is easily accessible and free to use for non-commercial research, that achieved a Class A recommendation.The BIS is the best currently available PROM of postpartum sleep. However, this PROM fails to assess several important domains such as sleep duration (and efficiency), chronotype, sleep-disordered breathing and medication usage. Future studies should focus on evaluating the psychometric measurement properties of BIS in the North American setting and in different cultural groups, or to develop a more specific PROM of postpartum sleep.
View details for DOI 10.1093/sleep/zsab128
View details for PubMedID 34013345
Use of Patient-Reported Outcome Measures to Assess Outpatient Postpartum Recovery: A Systematic Review.
JAMA network open
Sultan, P., Sharawi, N., Blake, L., Ando, K., Sultan, E., Aghaeepour, N., Carvalho, B., Sadana, N.
2021; 4 (5): e2111600
Outpatient postpartum recovery is an underexplored area of obstetrics. There is currently no consensus regarding which patient-reported outcome measure (PROM) clinicians and researchers should use to evaluate postpartum recovery.To evaluate PROMs of outpatient postpartum recovery using Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.An initial literature search performed in July 2019 identified postpartum recovery PROMs and validation studies. A secondary search in July 2020 identified additional validation studies. Both searches were performed using 4 databases (Web of Science, Embase, PubMed, and CINAHL), with no date limiters. Studies with PROMs evaluating more than 3 proposed outpatient postpartum recovery domains were considered. Studies were included if they assessed any psychometric measurement property of the included PROMs in the outpatient postpartum setting. The PROMs were assessed for the following 8 psychometric measurement properties, as defined by COSMIN: content validity, structural validity, internal consistency, cross-cultural validity and measurement invariance, reliability, measurement error, hypothesis testing, and responsiveness. Psychometric measurement properties were evaluated in each included study using the COSMIN criteria by assessing (1) the quality of the methods (very good, adequate, doubtful, inadequate, or not assessed); (2) overall rating of results (sufficient, insufficient, inconsistent, or indeterminate); (3) level of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations assessment tool; and (4) level of recommendation, which included class A (recommended for use; showed adequate content validity with at least low-quality evidence for sufficient internal consistency), class B (not class A or class C), or class C (not recommended).In total, 15 PROMs (7 obstetric specific and 8 non-obstetric specific) were identified, evaluating outpatient postpartum recovery in 46 studies involving 19 165 women. The majority of psychometric measurement properties of the included PROMs were graded as having very-low-level or low-level evidence. The best-performing PROMs that received class A recommendations were the Maternal Concerns Questionnaire, the Postpartum Quality of Life tool, and the World Health Organization Quality of Life-BREF. The remainder of the evaluated PROMs had insufficient evidence to make recommendations regarding their use (and received class B recommendations).This review found that the best-performing PROMs currently available to evaluate outpatient postpartum recovery were the Maternal Concerns Questionnaire, the Postpartum Quality of Life tool, and the World Health Organization Quality of Life-BREF; however, these tools all had significant limitations. This study highlights the need to focus future efforts on robustly developing and validating a new PROM that may comprehensively evaluate outpatient postpartum recovery.
View details for DOI 10.1001/jamanetworkopen.2021.11600
View details for PubMedID 34042993
A systematic review of patient-reported outcome measures used to assess postpartum pain using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.
British journal of anaesthesia
Sultan, P. n., Ando, K. n., Sultan, E. n., Hawkins, J. E., Chitneni, A. n., Sharawi, N. n., Sadana, N. n., Blake, L. E., Singh, P. M., Flood, P. n., Carvalho, B. n.
We performed a systematic review using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines to identify the best available patient-reported outcome measure (PROM) of postpartum pain.This review follows COSMIN guidelines. We searched four databases with no date limiters, for previously identified validated PROMs used to assess postpartum pain. PROMs evaluating more than one author-defined domain of postpartum pain were assessed. We sought studies evaluating psychometric properties. An overall rating was then assigned based upon COSMIN analysis, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the level of evidence for psychometric properties of included PROMs. These assessments were used to make recommendations and identify the best PROM to assess postpartum pain.We identified 19 studies using seven PROMs (involving 3511 women), which evaluated postpartum pain. All included studies evaluated ≥1 psychometric property of the included PROMs. An adequate number of pain domains was assessed by the Brief Pain Inventory (BPI), Short Form-BPI (SF-BPI), and McGill Pain Questionnaire (MPQ). The SF-BPI was the only PROM to demonstrate adequate content validity and at least a low-level of evidence for sufficient internal consistency, resulting in a Class A recommendation (the best performing instrument, recommended for use).SF-BPI is the best currently available PROM to assess postpartum pain. However, it fails to assess several important domains and only just met the criteria for a Class A recommendation. Future studies are warranted to develop, evaluate, and implement a new PROM designed to specifically assess postpartum pain.
View details for DOI 10.1016/j.bja.2021.03.035
View details for PubMedID 34016441
Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean.
Anesthesia and analgesia
Bollag, L. n., Lim, G. n., Sultan, P. n., Habib, A. S., Landau, R. n., Zakowski, M. n., Tiouririne, M. n., Bhambhani, S. n., Carvalho, B. n.
The purpose of this article is to provide a summary of the Enhanced Recovery After Cesarean delivery (ERAC) protocol written by a Society for Obstetric Anesthesia and Perinatology (SOAP) committee and approved by the SOAP Board of Directors in May 2019. The goal of the consensus statement is to provide both practical and where available, evidence-based recommendations regarding ERAC. These recommendations focus on optimizing maternal recovery, maternal-infant bonding, and perioperative outcomes after cesarean delivery. They also incorporate management strategies for this patient cohort, including recommendations from existing guidelines issued by professional organizations such as the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists. This consensus statement focuses on anesthesia-related and perioperative components of an enhanced recovery pathway for cesarean delivery and provides the level of evidence for each recommendation.
View details for DOI 10.1213/ANE.0000000000005257
View details for PubMedID 33177330
Comparison of spontaneous versus operative vaginal delivery using Obstetric Quality of Recovery-10 (ObsQoR-10): An observational cohort study.
Journal of clinical anesthesia
Sultan, P. n., Kormendy, F. n., Nishimura, S. n., Carvalho, B. n., Guo, N. n., Papageorgiou, C. n.
2020; 63: 109781
We aimed to determine whether patient-reported quality of recovery differed between spontaneous and operative vaginal delivery. We also aimed to psychometrically evaluate the Obstetric Quality of Recovery-10 scoring tool (ObsQoR-10) for use in this setting.Single center observational cohort study.Labour and delivery ward at a peripheral general hospital within the United Kingdom, over a 10-month period.123 women delivering via either spontaneous (n = 68) or operative vaginal delivery (n = 55).Women were asked to complete the ObsQoR-10 and global health visual analogue scale (0-100) on postpartum day 1. A convenience sample of consenting parturients delivering via spontaneous or operative vaginal delivery (forceps or vacuum assisted), were included. In total, 123 deliveries were included (68 via spontaneous and 55 via operative vaginal delivery), with no dropouts.Primary outcome was ObsQoR-10 score and secondary outcomes included measures of validity, reliability and feasibility of ObsQoR-10.Quality of recovery was better following spontaneous vaginal delivery. ObsQoR-10 scores were 80.2 (95% CI 76.4-83.9) and 72.1 (95% CI 67.3-76.9], (a difference in score of 8.1 [95% CI 2.1-14.0]) following spontaneous and operative vaginal delivery respectively (p = 0.008).ObsQoR-10 correlated with global health visual analogue scale score (R = 0.52; p = 0.01) and scores were higher in women requiring <36 h compared to ≥36 hour postpartum hospital stay (81.3 (95% CI 77.9-84.7) versus 72.6 (95% CI 67.9-77.2] hours respectively, (a difference in score of 8.7 [95% CI 2.8-14.6]; p = 0.004). Reliability: ObsQoR-10 demonstrated good internal consistency (Cronbach's alpha = 0.82 and inter-item correlation = 0.32) good split-half reliability (Spearman-Brown Prophesy Reliability Estimate = 0.88) and excellent test-re-test reliability (intra-class correlation coefficient of 0.86 [95% CI 0.72-0.93]). Feasibility: All women completed the survey with a median completion time of 2.5 min.Quality of recovery appears to be better following spontaneous compared to operative vaginal delivery. This study also demonstrates that ObsQoR-10 is a valid and reliable tool for use following these delivery modes.
View details for DOI 10.1016/j.jclinane.2020.109781
View details for PubMedID 32203873
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- Mhyre JM, Sultan P. General anesthesia for cesarean delivery: Occasionally essential but best avoided. Anesthesiology. 2019 Jun;130(6):864-866.
- Nanji JA, Guo N, Riley ET, Carvalho B. Impact of intraoperative dexamethasone after scheduled cesarean delivery: a retrospective study. Int J Obstet Anesth. 2019 Jun 24. doi: 10.1016/j.ijoa.2019.06.006
- Nanji JA, Guo N, Riley ET, Faulkner B, Do C, Carvalho B. Evaluation of opioid use with split doses of oral opioids in a postcesarean delivery analgesia order set. Obstet Gynecol. 2019; 44(5): 575-585.
- Oji-Zurmeyer J, Ortner CM, Klein KU, Gries M, Kühn C, Schroffenegger T, Putz G, Jochberger S. National survey of obstetric anaesthesia clinical practices in the republic of Austria. Int J Obstet Anesth. 2019 Aug;39:95-98. doi: 10.1016/j.ijoa.2019.02.002. Epub 2019 Feb 15.
- Ortner CM, Macias P, Neethling E, Krishnamoorty V, Carvalho B, Dyer RA. Ocular sonography in pre-eclampsia: a simple technique to detect raised intracranial pressure? Int J Obstet Anesth. 2019 Sep 20.
- Ortner CM, Krishnamoorthy V, Neethling E, Flint M, Swanevelder JL, Lombard C, Fawcus S, Dyer RA. Point-of-Care Ultrasound Abnormalities in Late-Onset Severe Preeclampsia: Prevalence and Association With Serum Albumin and Brain Natriuretic Peptide. Anesth Analg. 2019 Jun;128(6):1208-1216. doi: 10.1213/ANE.0000000000003759.
- Patel SD, Sharawi N, Sultan P. Local anaesthetic techniques for post caesarean delivery pain. Submitted to Int J Obstet Anesth 2019 Nov;40:62-77
- Riley E, Akbar K, Carvalho B. Intra-aortic balloon pump for cesarean hysterectomy and massive hemorrhage in a parturient with placenta accreta and pulmonary embolus: a case report. J Med Ultrasound 2019;27:104-6
- Riley ET, Mangum K, Carvalho B, Butwick AJ. The crystalloid co-load as effective as colloid preload for preventing hypotension from spinal anesthesia for cesarean delivery. Turk J Anaesthesiol Reanim. 2019; 47(1): 35-40
- Sharawi N, Klima L, Shah R, Blake L, Carvalho B, Sultan P. Evaluation of patient-reported outcome measures of functional recovery following caesarean section: a systematic review using the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist. Anaesthesia. 2019 Nov; 74(11):1439-1455.
- Sherman J, Hedli L, Kristensen-Cabrera A, Lipman S, Schwandt D, Lee H, Sie L, Halamek L, Austin N. Understanding the Heterogeneity of Labor and Delivery Units: Using Design Thinking Methodology to Assess Environmental Factors that Contribute to Safety in Childbirth. Am J Perinatol. 2019 Apr. doi: 10.1055/s-0039-168549
- Stewart M, Carvalho B, Tsui BCH. Electrical stimulation test for epidural catheter placement after receiving intrathecal local anesthetic during a combined spinal-epidural technique for Cesarean delivery: confirmation of the spinal nerve root as epidural site of action. Can J Anaesth. 2019 Nov 4
- Sultan P, Bampoe S, Shah R, N.Guo, J. Estes, Halpern S, Butwick A. Treatment of postpartum anemia using oral versus intravenous iron therapy: A systematic review. Am J Obstet Gynecol. 2019 Jul;221(1):19-29.e3.
- Sultan P, Bampoe S, Shah R, Guo N, Estes J, Stave C, Goodnough LT, Halpern S, Butwick AJ. Oral versus intravenous iron therapy for postpartum anemia: A systematic review and meta-analysis American Journal of Obstetrics and Gynecology 2019; 221: 19-29.e3
- Sutton CD, Carvalho B. Supraglottic airway rescue after failed fiberoptic intubation in a patient with osteogenesis imperfecta A A Pract. 2019 Jan 28. doi: 10.1213/XAA.0000000000000968.
- Terkawi AS, Bakri B, Alsadek AS, Alsibaee RH, Alasfar EM, Albakour AH, Aljouja AY, Alshaikhwais NA, Fares FA, Flood PD, Jnaid H Najib AA, Saloom DA, Zahra NA, Altirkawi KA. Women's health in northwestern syria: findings from healthy-syria 2017 study. Avicenna J Med. 2019; 9:94-106
- Ton TGN, Bennett MV, Incerti D, Peneva D, Druzin M, Stevens W, Butwick AJ, Lee HC. Maternal and Infant Adverse Outcomes Associated with Mild and Severe Preeclampsia during the First Year after Delivery in the United States. American Journal of Perinatology 2019 Feb 19. [Epub ahead of print]
- Wall-Wieler E, Carmichael SL, Gibbs RS, Lyell DL, Girsen AI, El-Sayed YY, Butwick AJ. Severe Maternal Morbidity among Stillbirth and Live Birth Deliveries in California Obstetrics and Gynecology 2019; 134: 310-17
- Weiniger CF, Maor A, Aptekman B, Carvalho B. Prospective investigation of the relationship between body habitus measurements and depth to epidural space and difficult neuraxial block in term pregnant women Acta Anaesthesiol Scand. 2019 Dec 31. doi: 10.1111/aas.13544.
- Yurashevich M, Carvalho B, Butwick AJ, Ando K, Flood P. Determinants of patient dissatisfaction with anesthesia care in labor and delivery. Anaesthesia 2019; 74:1112-1120
- Yurashevich M, Chow A, Kowalczyk J, Traynor AJ, Carvalho B. Preoperative fasting times for patients undergoing cesarean delivery: before and after a patient educational initiative. Turk J Anaesthesiol Reanim. 2019; 47(4): 282-286
- Ackland G, Gutierrez del Arroyo A, Sanchez J, Patel S, Phillips S, Reyes A, Sultan P, David A. Caspase-1 and epidural-related maternal fever. Br J Anaesth. 2018;120:e20-e21.
- Austin N, Kristensen-Cabrera A, Sherman J, Schwandt D, McDonald A, Hedli L, Lipman S, Daniels K, Lee H. Analyzing the heterogeneity of labor and delivery units: a quantitative analysis of space and design. PLoS One. 2018;13:e0209339.
- Bagdas D, Gurunc MS, Flood P, Papkee RL, Damaj MI. New insights on neuronal nicotinic acetylcholine receptors as targets for pain and inflammation: a focus on α7 nAChRs. Curr Neuropharmacol. 2018;16:415-25.
- Buchan T, Walkden M, Jenkins K, Sultan P, Bandula S. High frequency jet ventilation during cryoablation of small renal tumours. Cardiovasc Intervent Radiol. 2018;41:1067-73.
- Butwick AJ, Abreo A, Bateman BT, Lee HC, El-Sayed YY, Stephansson O, Flood P. Effect of body mass index on postpartum hemorrhage. Anesthesiology. 2018;128: 774-83.
- Butwick A, Bentley J, Leonard SA, Carmichael SL, EI-Sayed YY, Stephansson O, Guo N. Prepregnancy maternal body mass index and venous thromboembolism: a population based cohort study. BJOG. Nov 30. doi: 10.1111/1471-0528.15567. [Epub ahead of print]
- Butwick A, Bentley J, Wong CA, Snowden JM, Sun E, Guo N. United States state-level variation in the use of neuraxial analgesia during labor for pregnant women. JAMA Netw Open. 2018;1:e186567.
- Butwick AJ, Palanisamy A. Mode of anesthesia for cesarean delivery and maternal morbidity: can we overcome confounding by indication? Br J Anaesth. 2018;120:621-3.
- Butwick A, Walsh EM, Kuzniewicz M, Li SX, Escobar GJ. Accuracy of international classification of diseases, ninth revision, codes for postpartum hemorrhage among women undergoing cesarean delivery. Transfusion. 2018;58:998-1005.
- Butwick AJ, Wong CA, Guo N. Maternal body mass index and use of labor neuraxial analgesia: a population-based retrospective cohort study. Anesthesiology. 2018;129:448-58.
- Cobb B, Abir G, Carvalho B. Preoperative anterior thigh temperature does not correlate with perioperative temporal hypothermia during cesarean delivery with spinal anesthesia: secondary analysis of a randomized control trial. Int J Obstet Anesth. 2018;33:40-5.
- Darnall BD, Ziadni MS, Stieg RL, Mackey IG, Kao MC, Flood P. Patient-centered prescription opioid tapering in community outpatients with chronic pain. JAMA Intern Med. 2018; 178:707-8.
- Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, Watson PL, Weinhouse GL, Nunnally ME, Rochwerg B, Balas MC, van den Boogaard M, Bosma KJ, Brummel NE, Chanques G, Denehy L, Drouot X, Fraser GL, Harris JE, Joffe AM, Kho ME, Kress JP, Lanphere JA, McKinley S, Neufeld KJ, Pisani MA, Payen JF, Pun BT, Puntillo KA, Riker RR, Robinson BRH, Shehabi Y, Szumita PM, Winkelman C, Centofanti JE, Price C, Nikayin S, Misak CJ, Flood PD, Kiedrowski K, Alhazzani W. Executive summary: clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46:1532-48.
- Devlin JW, Skrobik Y, Rochwerg B, Nunnally M, Needham DM, Gelinas C, Pandharipande P, Slooter AA, Watson P, Weinhouse G, Kho ME, Centofan J, Price C, Harmon L, Misak C, Flood P, Alhazzani W. Methodological innovation in creating clinical practice guidelines: insights from the 2018 SCCM pain, agitation (sedation), delirium, immobility and sleep (disruption) guideline effort. Crit Care Med. 2018;46:1457-63.
- Du L, Wenning L, Migoya E, Xu Y, Carvalho B, Brookfield K, Witjes H, de Greef R, Lumbiganon P, Sangkomkamhang U, Titapant V, Duley L, Long Q, Oladapo OT. Population pharmacokinetic modeling to evaluate standard magnesium sulfate treatments and alternative dosing regimens for pregnant women with preeclampsia. J Clin Pharmacol. 2018 Nov 13. doi: 10.1002/jcph.1328. [Epub ahead of print]
- Eisenried A, Austin N, Cobb B, Akhbardeh A, Carvalho B, Yeomans DC, Tzabazis AZ. Correlation of changes in hemodynamic response as measured by cerebral optical spectrometry with subjective pain ratings in volunteers and patients: a prospective cohort study. J Pain Res. 2018;11:1991-8.
- Fedoruk K, Seligman KM, Carvalho B, Butwick AJ. Assessing the association between blood loss and postoperative hemoglobin after cesarean delivery: a prospective study of 4 blood loss measurement modalities. Anesth Analg. 2018 May 25. doi: 10.1213/ANE.0000000000003449. [Epub ahead of print]
- Fischer A, Ortner CM, Hartmann T, Jochberger S, Klein KU. Which medications are safe for breastfeeding? A synopsis for the anesthetist, obstetrician and pediatrician. Wien Med Wochenschr. 2018 Apr 24. doi: 10.1007/s10354-018-0637-z. [Epub ahead of print]
- Guo N, Robakis T, Miller C, Butwick A. Prevalence of depression among women of reproductive age in the United States.Obstet Gynecol. 2018;131:671-9.
- Ho PT, Carvalho B, Sun EC, Macario A, Riley ET. Cost-benefit analysis of maintaining a fully stocked malignant hyperthermia cart versus an initial dantrolene treatment dose for maternity units. Anesthesiology. 2018;129:249-59.
- Howle R, Ciechanowicz S, Heppolette C, Nakhjavani B, Sultan P. Validation of an obstetric quality of recovery scoring tool (ObsQoR-11) after emergency caesarean delivery. Br J Anaesth. 2018;121:e19-e20.
- Komatsu R, Carvalho B, Flood P. Prediction of pain, analgesia requirement and recovery of function after childbirth. Br J Anaesth. 2018;121:417-26.
- Leffert L, Butwick A, Arendt K, Bates S, Boehlen F, Fernando R, Friedman A, Horlocker T, Kopp S, Montgomery D, Pellegrini J, Smiley R, Toledo P, Carvalho B, Landau IR. The Society for Obstetric Anesthesia and Perinatology consensus statement on the anesthetic management of pregnant and postpartum women receiving thromboprophylaxis or higher dose anticoagulants. Anesth Analg. 2018; 126:928-44.
- Nanji JA, Carvalho B. Modern techniques to optimize neuraxial labor analgesia. Anesth Pain Med. 2018;13:233-40.
- Ng S, Sodha S, Habib AS, Carvalho B, Sultan P. High-dose versus low-dose local anesthetic for transversus abdominis plane block post-cesarean delivery analgesia - a meta-analysis. Br J Anaesth. 2018;120:252-63.
- Ortner CM, Krishnamoorthy V, Neethling E, Flint M, Swanevelder JL, Lombard C, Fawcus S, Dyer RA. Point-of-care ultrasound abnormalities in late onset severe preeclampsia: prevalence and association with serum albumin and brain natriuretic peptide. Anesth Analg. 2018 Sep 10. doi: 10.1213/ANE.0000000000003759. [Epub ahead of print]
- Palmer E, Ciechanowicz S, Reeve A, Harris S, Wong DJN, Sultan P. Operating room-to-incision interval and neonatal outcome in emergency caesarean section: a retrospective 5-year cohort study. Anaesthesia. 2018;73:825-31.
- Patel SD, Habib AS, Phillips S, Carvalho B, Sultan P. The effect of glycopyrrolate on the incidence of hypotension and vasopressor requirement during spinal anesthesia for cesarean delivery: a meta-analysis. Anesth Analg. 2018;126:552-8.
- Pushpanathan E, Setty T, Carvalho B, Sultan P. A systematic review of postoperative pain outcome measurements utilised in regional anesthesia randomized controlled trials. Anesthesiol Res Prac. 2018;2018:9050239.
- Riley ET. Comment on arachnoid and dura mater lesions. Reg Anesth Pain Med. 2018;43:332.
- Riley ET, Dyer RA, Carvalho B. Left uterine tilt for cesarean delivery significantly improves maternal hemodynamics and should not be considered outdated dogma. Anesthesiology. 2018;128:858-9.
- Seligman KM, Weiniger CF, Carvalho B. The accuracy of a handheld ultrasound device for neuraxial depth and landmark assessment: a prospective cohort trial. Anesth Analg. 2018;126:1995-8.
- Sharawi N, Carvalho B, Habib AS, Blake L, Mhyre JM, Sultan P. A systematic review evaluating neuraxial morphine and diamorphine associated respiratory depression following cesarean delivery. Anesth Analg. 2018;127:1385-95.
- Sloan R, Shapiro P, McKinley P, Bartels M, Shimbo D, Lauriola V, Karmally W, Choi C, Choo T, Scodes J, Flood P, Tracey KJ. Aerobic exercise training and systemic inflammation: results of a randomized controlled trial. J Am Heart Ass. 2018;7:e010201.
- Tan, M, Lipman S, Lee H, Sie L, Carvalho B. Evaluation of electronic medical records on nurses’ time allocation during cesarean delivery. J Patient Saf. 2018 Feb 26 doi: 10.1097/PTS.0000000000000467. [Epub ahead of print]
- Weber U, Schiefer J, Muehlbacher J, Bernardi M, Ortner CM, Jaksch P. High altitude trekking after lung transplantation: a prospective study using lung ultrasound to detect comet tails for interstitial pulmonary edema in lung transplant recipients and healthy volunteers. Transpl Int. 2018;31:1245-53.
- Weiniger CF, Akdagli S, Turval E, Carvalho B. Prospective observational investigation of capnography and pulse oximetry monitoring after cesarean delivery with intrathecal morphine. Anesth Analg. 2018 Jun 28. doi: 10.1213/ANE.0000000000003503. [Epub ahead of print]
- Weiniger CF, Cobb B, Wang RR. Carvalho B. Observational study using ultrasound to assess midline labor epidural analgesia placement and analgesic efficacy. J Ultrasound Med. 2018;37:1693-9.
- Zackler A, Flood P, Dajao R, Maramara L, Goetzl L. Suspected chorioamnionitis and myometrial contractility: mechanisms for increased risk of cesarean delivery and postpartum hemorrhage. Reprod Sci. 2018 Jan 1:1933719118778819. doi: 10.1177/1933719118778819. [Epub ahead of print]
- Abir G, Akdagli S, Butwick A, Carvalho B. Clinical and microbiological features of maternal sepsis: a retrospective study. Int J Obstet Anesth. 2017;29:26-33.
- Abir G, Mhyre J. Maternal mortality and the role of the obstetric anesthesiologist. Best Pract Res Clin Anaesthesiol. 2017;31:91-105.
- Bateman BT, Cole NM, Maeda A, Burns SM, Houle TT, Huybrechts KF, Clancy CR, Hopp SB, Ecker JL, Ende H, Grewe K, Corradini BR, Schoenfeld RE, Sankar K, Day LJ, Harris LC, Booth JL, Flood P, Bauer ME, Tsen LC, Leffert LR, Landau R. Patterns of opioid prescription and use after cesarean delivery. Obstet Gynecol. 2017;130:29-35.
- Betti F, Carvalho B, Riley ET. Intrathecal migration of an epidural catheter while using a programmed intermittent epidural bolus technique for labor analgesia maintenance: a case report. A A Case Rep. 2017;9:357-9.
- Brookfield KF, Elkomy M, Su F, Drover DR, Carvalho B. Optimization of maternal magnesium sulfate administration for fetal neuroprotection: application of a prospectively constructed pharmacokinetic model to the BEAM cohort. J Clin Pharmacol. 2017;57:1419-24.
- Butwick A. Improving post-caesarean analgesia: where to next? BJOG. 2017;124:1071.
- Butwick AJ, Ramachandran B, Hegde P, Riley ET, El-Sayed YY, Nelson LM. Risk factors for severe postpartum hemorrhage after cesarean delivery: case-control studies. Anesth Analg. 2017;125:523-32.
- Butwick AJ, Walsh EM, Kuzniewicz M, Li SX, Escobar GJ. Patterns and predictors of severe postpartum anemia after cesarean section. Transfusion. 2017;57:36-44.
- Carvalho B, Bateman B. Not too little, not too much: finding the goldilocks zone for spinal anesthesia to facilitate external cephalic version. Anesthesiology. 2017;127:596-8.
- Carvalho B, Butwick AJ. Postcesarean delivery analgesia. Best Pract Res Clin Anaesthesiol. 2017;31:69-79.
- Carvalho B, Mirza F, Flood P. Patient choice compared with no choice of intrathecal morphine dose for caesarean analgesia: a randomized clinical trial. Br J Anaesth. 2017;118:762-71.
- Carvalho B, Riley ET. Programmed intermittent epidural boluses (PIEB) for maintenance of labor analgesia: an incremental step before the next paradigm shift? Turk J Anaesthesiol Reanim. 2017;45:73-5.
- 13. Carvalho B, Weiniger CF. A perspective on hypercapnia events after cesarean delivery in women receiving intrathecal morphine. Anesth Analg. 2017;125:355-6.
- Carvalho B, Zheng LL, Butwick A. Comparative effectiveness of lower leg compression devices versus sequential compression devices to prevent postspinal hypotension during cesarean delivery. Anesth Analg. 2017;124:696-7.
- Chin KJ, McDonnell JG, Carvalho B, Sharkey A, Pawa A, Gadsden J. Essentials of our current understanding: abdominal wall blocks. Reg Anesth Pain Med. 2017;42:133-83.
- Cobb B, Lipman S. Cardiac arrest: obstetric CPR/ACLS. Clin Obstet Gynecol. 2017;60:425-30.
- Daniels K, Hamilton C, Crowe S, Lipman S, Halamek LP, Lee HC. Opportunities to foster efficient communication in labor and delivery using simulation. AJP Rep. 2017;7:e44-e48.
- Desai N, Carvalho B. General anaesthesia for caesarean section: is the end in sight for thiopental? Br J Hosp Med (Lond). 2017;78:358.
- Duffield A, McKenzie C, Carvalho B, Ramachandran B, Yin V, El-Sayed YY, Riley ET, Butwick AJ. Effect of a high-rate versus a low-rate oxytocin infusion for maintaining uterine contractility during elective cesarean delivery: a prospective randomized clinical trial. Anesth Analg. 2017;124:857-62.
- Duffield A, Sultan P, Riley ET, Carvalho B. Optimal administration of cefazolin prophylaxis for cesarean delivery. J Perinatol. 2017;37:16-20.
- Farr A, Holzer I, Einig S, Ortner CM, Lenz-Gebhart A, Lehner R. Outcomes and trends of peripartum maternal admission to the intensive care unit. Wien Klin Wochenschr. 2017;129:605-11.
- Jochberger S, Klein KU, Ortner CM. Schmerztherapie während der Geburt (Pain management during labor). Wien Med Wochenschr. 2017;167:368-73.
- Komatsu R, Carvalho B, Flood P. Recovery after nulliparous birth: a detailed analysis of pain analgesia and recovery of function. Anesthesiology. 2017;127;684-94
- Kowalczyk JJ, Bause GS. From Danielsville to doctor's day: Crawford W. Long, MD, the first surgical and first obstetric etherist. J Anesth Hist. 2017;3:31-2.
- Kumar G, Howard SK, Kou A, Kim TE, Butwick AJ, Mariano ER. Availability and readability of online patient education materials regarding regional anesthesia techniques for perioperative pain management. Pain Med. 2017;18:2027-32.
- Leffert LR, Dubois HM, Butwick AJ, Carvalho B, Houle TT, Landau R. Neuraxial anesthesia in obstetric patients receiving thromboprophylaxis with unfractionated or low-molecular-weight heparin: a systematic review of spinal epidural hematoma. Anesth Analg. 2017;125:223-31.
- Mayo-Wilson E, Li T, Fusco N, Bertizzolo L, Canner JK, Cowley T, Doshi P, Ehmsen J, Gresham G, Guo N, Haythornthwaite JA, Heyward J, Hong H, Pham D, Payne JL, Rosman L, Stuart EA, Suarez-Cuervo C, Tolbert E, Twose C, Vedula S, Dickersin K. Cherry-picking by trialists and meta-analysts can drive conclusions about intervention efficacy. J Clin Epidemiology. 2017;91:95-110.
- McKenzie C, Akdagli S, Abir G, Carvalho B. Postpartum tubal ligation: a retrospective review of anesthetic management at a single institution and a practice survey of academic institutions. J Clin Anesth. 2017;43:39-46.
- Miller CM, Cohn S, Akdagli S, Carvalho B, Blumenfeld YJ, Butwick AJ. Postpartum hemorrhage following vaginal delivery: risk factors and maternal outcomes. J Perinatol. 2017;37:243-8.
- Moy DM, Kim TE, Harrison TK, Leng JC, Carvalho B, Howard SK, Shum C, Kou A, Mariano ER; Anesthesiology-Directed Advanced Procedural Training (ADAPT) Research Group. Comparative echogenicity of an epidural catheter and 2 new catheters designed for ultrasound-guided continuous peripheral nerve blocks. J Ultrasound Med. 2017;36:2571-6.
- Nekhendzy V, Ramaiah VK, Collins J, Lemmens HJ, Most SP. The safety and efficacy of the use of the flexible laryngeal mask airway with positive pressure ventilation in elective ENT surgery: a 15-year retrospective single-center study. Minerva Anestesiol. 2017;83:947-55.
- Panigrahi AK, Yeaton-Massey A, Bakhtary S, Andrews J, Lyell DJ, Butwick AJ, Goodnough LT. A standardized approach for transfusion medicine support in patients with morbidly adherent placenta. Anesth Analg. 2017;125:603-8.
- Phillips S, Subair S, Husain T, Sultan P. Apnoeic oxygenation during maternal cardiac arrest in a parturient with extreme obesity. Int J Obstet Anesth. 2017;29:88-90.
- Rahman S, Walker D, Sultan P. Medical identification jewellery: an opportunity to save lives or an unreliable hindrance? Anaesthesia. 2017;72:1139-45.
- Riley ET. Comment on Montenigro et al., "Cumulative head impact exposure predicts later-life depression, apathy, executive dysfunction, and cognitive impairment in former high school and college football players". J Neurotrauma. 2017;34:1490.
- Riley ET, Carvalho B. Programmed intermittent epidural boluses (PIEB) for maintenance of labor analgesia: a superior technique to continuous epidural infusion? Turk J Anaesthesiol Reanim. 2017;45:65-6.
- Seligman K, Ramachandran B, Hegde P, Riley ET, El-Sayed YY, Nelson LM, Butwick AJ. Obstetric interventions and maternal morbidity among women who experience severe postpartum hemorrhage during cesarean delivery. Int J Obstet Anesth. 2017;31:27-36.
- Shaylor R, Weiniger CF, Austin N, Tzabazis A, Shander A, Goodnough LT, Butwick AJ. National and international guidelines for patient blood management in obstetrics: a qualitative review. Anesth Analg. 2017;124:216-32.
- Sultan P, Habib A, Carvalho B. Ambient operating room temperature: mother, baby or surgeon? Br J Anaesth. 2017;119:839.
- Sutton CD, Butwick AJ, Riley ET, Carvalho B. Nitrous oxide for labor analgesia: utilization and predictors of conversion to neuraxial analgesia. J Clin Anesth. 2017;40:40-5.
- Sutton CD, Carvalho B. Optimal pain management after cesarean delivery. Anesthesiol Clin. 2017;35:107-24.
- Sutton C, Carvalho B. What's trending now? An analysis of trends in internet searches for labor epidurals. Int J Obstet Anesth. 2017;30:52-7.
- Takazawa T, Choudhury P, Tong CK, Conway CM, Scherrer G, Flood PD, Mukai J, MacDermott AB. Inhibition mediated by glycinergic and GABAergic receptors on excitatory neurons in mouse superficial dorsal horn is location-specific but modified by inflammation. J Neurosci. 2017;37:2336-48.
- Van Erp M, Ortner CM, Jochberger S, Klein KU. Aktuelle versorgungskonzepte in der geburtshilflichen anästhesie (Recent standards in management of obstetric anesthesia). Wien Med Wochenschr. 2017;167:374-89.
- Wang M, He M, Wu B, Ke L, Han T, Wang J, Shan H, Ness P, Guo N, Liu Y, Nelson K. The association of elevated alanine aminotransferase levels with hepatitis E virus infections among blood donors in China. Transfusion. 2017;57:273-9.
- Weiniger CF, Carvalho B, Landau R. Optimal and timely triggers for vital signs-controlled, patient-assisted intravenous analgesia (VPIA) using remifentanil for labour and delivery analgesia. Anaesthesia. 2017;72:1155-6.
- Weiniger CF, Carvalho B, Stocki D, Einav S. Analysis of physiological respiratory variable alarm alerts among laboring women receiving remifentanil. Anesth Analg. 2017;124:1211-8.
- Ansari J, Carvalho B, Shafer S, Flood P. Pharmacokinetics and pharmacodynamics of drugs commonly used in pregnancy and parturition. Anesth Analg. 2016;122:786-804.
- Austin N, Goldhaber-Fiebert S, Daniels K, Arafeh J, Grenon V, Welle D, Lipman S. Building comprehensive strategies for obstetric safety: simulation drills and communication. Anesth Analg. 2016;123:1181-90.
- Brookfield KF, O'Malley K, El-Sayed YY, Blumenfeld YJ, Butwick AJ. Does time of delivery influence the risk of neonatal morbidity? Am J Perinatol. 2016;33:502-9.
- Brookfield KF, Su F, Drover DR, Elkomy MH, Adelus M, Lyell DJ, Carvalho B. Pharmacokinetics and placental transfer of magnesium sulfate in pregnant women. Am J Obstet Gynecol. 2016;214:737.e1-9.
- Butwick A, Blumenfeld Y, Brookfield K, Weiniger CF. Racial and ethnic disparities in mode of anesthesia for cesarean delivery. Anesth Analg. 2016;122:472-9.
- Butwick AJ, Tiouririne M. Evaluation of high-risk obstetric patients: a survey of US academic centers. J Clin Anesth. 2016;33:460-8.
- Carvalho B, George RB, Cobb B, McKenzie C, Riley ET. Implementation of programmed intermittent epidural bolus for the maintenance of labor analgesia. Anesth Analg. 2016;123:965-71.
- Carvalho B, Granot M, Sultan P, Wilson H, Landau R. A longitudinal study to evaluate pregnancy-induced endogenous analgesia and pain modulation. Reg Anesth Pain Med. 2016;41:175-80.
- Carvalho B, Mhyre JM. Moving beyond the 0-10 scale for labor pain measurement. Anesth Analg. 2016;123:1351-3.
- Carvalho B, Zheng M, Harter S, Sultan P. A prospective cohort study evaluating the ability of anticipated pain, perceived analgesic needs, and psychological traits to predict pain and analgesic usage following cesarean delivery. Anesthesiol Res Pract. 2016;2016:7948412 .
- Cobb B, Cho Y, Hilton G, Ting V, Carvalho B. Active warming utilizing combined intravenous fluid and forced-air warming decreases hypothermia and improves maternal comfort during cesarean delivery. Anesth Analg. 2016;122:1490-7.
- Darnall B, Wheeler A, Taub C, Mackey I, Wapnir I, Schultz C, Rico T, Flood P. An internet-based perioperative pain psychology treatment program: results of a randomized controlled trial in breast oncology surgery patients. J Pain. 2016;17:S106.
- Degos V, Flood P. Are epigenetic changes the key to the elusive mechanism for the long-lasting effects of anesthetic drugs that persist after emergence? Anesthesiology. 2016;124:530-1.
- Farber MK, Miller CM, Ramachandran B, Hegde P, Akbar K, Goodnough LT, Butwick AJ. Knowledge of blood loss at delivery among postpartum patients. Peer J. 2016;4:e2361.
- Flood P, Clark JD. Molecular interaction between stress and pain. Anesthesiology. 2016;124:994-5.
- Fragiadakis GK, Baca QJ, Gherardini PF, Ganio EA, Gaudilliere DK, Tingle M, Lancero HL, McNeil LS, Spitzer MH, Wong RJ, Shaw GM, Darmstadt GL, Sylvester KG, Winn VD, Carvalho B, Lewis DB, Stevenson DK, Nolan GP, Aghaeepour N, Angst MS, Gaudilliere BL. Mapping the fetomaternal peripheral immune system at term pregnancy. J Immunol. 2016;197:4482-92.
- Hilton G, Daniels K, Carvalho B. Simulation study assessing healthcare provider's knowledge of preeclampsia and eclampsia in a tertiary referral center. Simul Healthc. 2016;11:25-31.
- Hilton G, Daniels K, Goldhaber-Fiebert SN, Lipman S, Carvalho B, Butwick A. Checklists and multidisciplinary team performance during simulated obstetric hemorrhage. Int J Obstet Anesth. 2016;25:9-16.
- Hu LQ, Flood P, Li Y, Tao W, Zhao P, Xia Y, Pian-Smith MC, Stellaccio FS, Ouanes JP, Hu F, Wong CA. No pain labor & delivery: a global health initiative's impact on clinical outcomes in China. Anesth Analg. 2016;122:1931-8.
- Ioscovich A, Shatalin D, Butwick AJ, Ginosar Y, Orbach-Zinger S, Weiniger CF. Israeli survey of anesthesia practice related to placenta previa and accreta. Acta Anaesthesiol Scand. 2016;60:457-64.
- Lipman S, Cohen SE, Mhyre J, Carvalho B, Einav S, Arafeh J, Jeejeebhoy F, Cobb B, Druzin M, Katz V, Harney K. Challenging the 4- to 5-minute rule: from perimortem cesarean to resuscitative hysterotomy. Am J Obstet Gynecol. 2016;215:129-31.
- McKenzie CP, Carvalho B, Riley ET. The Wiley spinal catheter-over-needle system for continuous spinal anesthesia: a case series of 5 cesarean deliveries complicated by paresthesias and headaches. Reg Anesth Pain Med. 2016;41:405-10.
- McKenzie CP, Cobb B, Riley ET, Carvalho B. Programmed intermittent epidural boluses for maintenance of labor analgesia: an impact study. Int J Obstet Anesth. 2016;26:32-8.
- Miller CM, Ramachandran B, Akbar K, Carvalho B, Butwick AJ. The impact of postpartum hemoglobin levels on maternal quality of life after delivery: a prospective exploratory study. Ann Hematol. 2016;95:2049-55.
- Osmundson SS, Gould JB, Butwick AJ, Yeaton-Massey A, El-Sayed YY. Labor outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2016;214:362.e1-7.
- Riley ET. Chronic traumatic encephalopathy and professional athletes: suicides are contagious. World Neurosurg. 2016;94:576-7.
- Sultan P, Halpern SH, Pushpanathan E, Patel S, Carvalho B. Effect of intrathecal morphine dose for cesarean delivery on maternal and neonatal outcomes: a meta-analysis. Anesth Analg. 2016;123:154-64.
- Sultan P, Seligman K, Carvalho B. Amniotic fluid embolism: update and review. Curr Opin Anaesthesiol. 2016;29:288-96.
- Sultan P, Weiniger CF, Carvalho B. Neuraxial blockade increases external cephalic version success: a well-known finding needing to be disseminated within the obstetric domain. Am J Obstet Gynecol. 2016;215:675-6.
- Sultan P, David AL, Fernando R, Ackland GL. Inflammation and epidural-related maternal fever: proposed mechanisms. Anesth Analg. 2016;122:1546-53.
- Sutton C, Butwick A. Can extra carbs improve perinatal outcomes? BJOG. 2016;123:518
- Tawfik V, Flood P. Electrical synapses: high-speed communication in the maintenance of neuropathic pain. Anesthesiology. 2016;124:13-5.
- Terkawi AS, Mavridis D, Flood P, Wetterslev J, Terkawi RS, Bin Abdulhak AA, Nunemaker MS, Tiouririne M. Does ondansetron modify sympathectomy due to subarachnoid anesthesia?: Meta-analysis, meta-regression, and trial sequential analysis. Anesthesiology. 2016;124:846-69.
- Traynor AJ, Aragon M, Gosh D, Choi R, Dingmann C, Bucklin BA. The obstetric anesthesia workforce survey: a 30-year update. Anesth Analg. 2016;122:1939-46.
- Van de Velde M, Carvalho B. Remifentanil for labor analgesia: an evidence-based narrative review. Int J Obstet Anesth. 2016;25:66-74.
- Weiniger CF, Sultan P, Dunn A, Carvalho B. Survey of external cephalic version for breech presentation and neuraxial blockade use. J Clin Anesth. 2016;34:616-22.
- Anast N, Kwok J, Carvalho B, Lipman S, Flood P. Intact survival after obstetric hemorrhage and 55 minutes of cardiopulmonary resuscitation. A A Case Rep. 2015;5:9-12.
- Beswick DM, Collins J, Nekhendzy V, Damrose EJ. Chondronecrosis of the larynx following use of the laryngeal mask airway. Laryngoscope. 2015;125:946-9.
- Blumenfeld YJ, El-Sayed YY, Lyell DJ, Nelson LM, Butwick AJ. Risk factors for prolonged postpartum length of stay following cesarean delivery. Am J Perinatol. 2015;32:825-32.
- Brookfield KF, El-Sayed YY, Chao L, Berger V, Naqvi M, Butwick AJ. Antenatal corticosteroids for preterm premature rupture of membranes: single or repeat course? Am J Perinatol. 2015;32:537-44.
- Butwick A, Blumenfeld Y, El-Sayed YY, Osmundson SS, Weiniger CF. Mode of anaesthesia for preterm caesarean delivery: secondary analysis from the Maternal-Fetal Medicine Units Network Caesarean Registry. Br J Anaesth. 2015;115:267-74.
- Butwick AJ, Carvalho B, Blumenfeld YJ, El-Sayed YY, Nelson LM, Bateman BT. Second-line uterotonics and the risk of hemorrhage-related morbidity. Am J Obstet Gynecol. 2015;212:e1-7.
- Butwick A, Columb M, Carvalho B. Vasopressors and spinal hypotension during cesarean delivery: what’s the latest? Br J Anaesth. 2015;114:183-6.
- Butwick A, Goodnough LT. Transfusion and coagulation management in major obstetric hemorrhage. Curr Opin Anaesthesiol. 2015;28:275-84.
- Butwick A, Gutierrez M, Hilton G. The impact of advanced maternal age on peripartum thromboelastographic coagulation profiles: a prospective observational exploratory study. Can J Anaesth. 2015;62:504-12.
- Camann W, McGovern C, Collins M, Baysinger C, Vallejo M, Anderson J, Wood C, Hawkins JL, Carvalho B, Rollins M, Bishop J, Brumley J. How to say “YES” to nitrous oxide for labor. SOAP Newsletter, Summer 2015.
- Carvalho B, Dyer RA. Norepinephrine for spinal hypotension during cesarean delivery: another paradigm shift? Anesthesiology. 2015;122:728-30.
- Carvalho B, Wong C. Drug labeling in the practice of obstetric anesthesia. Am J Obstet Gynecol. 2015;212:24-7.
- Carvalho B, Yun RD, Mariano ER. Continuous versus single-Injection peripheral nerve blocks: a pilot study comparing procedural time and estimated personnel cost. The Open Anesthesia Journal 2015;9:1-5.
- Cobb B, Lipman S. An update on the American Heart Association Scientific Statement on Cardiac Arrest in Pregnancy. Published in Circulation October 2015. SOAP Newsletter, Winter 2015.
- Creanga AA, Bateman BT, Butwick AJ, Rayleigh L, Maeda A, Kuklina E, Callaghan WM. Morbidity associated with cesarean delivery in the United States: is placenta accreta an increasingly important contributor? Am J Obstet Gynecol. 2015;213:384.e1-11.
- Edwards MR, Sultan P, Gutierrez Del Arroyo A, Whittle J, Karmali SN, Moonesinghe SR, Haddad FS, Mythen MG, Singer M, Ackland GL. Metabolic dysfunction in lymphocytes promotes postoperative morbidity. Clin Sci (Lond). 2015;129:423-437.
- Elkomy MH, Sultan P, Clavijo C, Galinkin JL, Carvalho B, Drover DR. Ondansetron pharmacokinetics in pregnant women and neonates: towards a new treatment for neonatal abstinence syndrome. Clin Pharmacol Ther. 2015;97:167-76.
- Flood P, Dexter F, Ledolter J and Dutton RP. Large heterogeneity in mean durations of labor analgesia among hospitals reporting to the American Society of Anesthesiologist’s Anesthesia Quality Institute. Anesth Analg. 2015;121:1283-9.
- Flood P, McKinley P, Monk C, Muntner P, Colantonio L, Goetzl L, Hatch M, Sloan R. Beat-to-beat heart rate and blood pressure variability and hypertensive disease in pregnancy. Am J Perinatol. 2015;32:1050-8.
- Girsen AI, Greenberg MB, El-Sayed YY, Carvalho B, Lyell DJ. Magnesium sulfate exposure and neonatal intensive care unit admission. J Perinatol. 2015;35:181-5.
- Golovanevski L, Ickowicz DE, Sokolsky-Papkov M, Domb AJ, Weiniger CF. Biocompatibility of an extended release bupivacaine formulation following site-directed nerve injection. J Bioact Compat Polym. 2015;30:114-125.
- Jeejeebhoy FM, Zelop CM, Lipman S, Carvalho B, Joglar J, Mhyre JM, Katz VL, Lapinsky SE, Einav S, Warnes CA, Page RL, Griffin RE, Jain A, Dainty KN, Arafeh J, Windrim R, Koren G, Callaway C. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132:1747-73.
- Karmali S, Jenkins N, Sciusco A, John J, Haddad F, Ackland GL; POM-X Study Investigators (Reyes A, Davies K, Edwards J, Whittle J, Barnett S, Moonesinghe S, Wyndham D, Bettini E, Lee S, Sultan P, Edwards M, Cain D, del Arroyo A). Randomized controlled trial of vagal modulation by sham feeding in elective non-gastrointestinal (orthopaedic) surgery. Br J Anaesth. 2015;115:727-35.
- Li Y, Flood P, Cornes S. Electroencephalography of seizure-like movements during general anesthesia with propofol: seizures or nonepileptic events? A A Case Rep. 2015;5:195-8.
- Liu YM, Patel SD, Mon W, Fernando R, Columb M, Sultan P. Maternal fever and epidural insertion: an OAA approved survey. Int J Obstet Anesth. 2015;24:S28.
- Paech M, Sng BL, Sia A, Ng L, Nathan E, Carvalho B. Methylnaltrexone to prevent intrathecal morphine-induced pruritus after caesarean delivery: a multicenter randomized clinical trial. Br J Anaesth. 2015;114:469-76.
- Rhee KY, Goetzl L, Unal R, Cierny J, Flood P. Relationship between plasma inflammatory cytokines and labor pain. Anesth Analg. 2015;121:748-51.
- Rodriguez CI, Kegeles LS, Levinson A, Ogden R, Mao X, Milak MS, Vermes D, Xie S, Hunter L, Flood P, Moore H, Shungu DC, Simpson HB. In vivo effects of ketamine on glutamate-glutamine and gamma-aminobutyric acid in obsessive-compulsive disorder. Psychiatry Res. 2015;233:141-7.
- Soltanifar D, Bogod D, Harrison S, Carvalho B, Sultan P. A survey of accepted practice following failed intubation for emergency caesarean delivery. Anesthesiol Res Pract. 2015;2015:192315.
- Soltanifar D, Carvalho B, Sultan P. Perioperative considerations of the patient with malaria. Can J Anaesth. 2015;62:304-18.
- Soltanifar D, Jacobs M, Jones T, McGlennan A, Sultan P. Spinal anaesthesia for emergency caesarean delivery in a parturient with falciparum malaria. Int J Obstet Anesth. 2015;24:91.
- Sultan P, Habib AS, Cho Y, Carvalho B. The effect of patient warming during caesarean delivery on maternal and neonatal outcomes: a meta-analysis. Br J Anesth. 2015;115:500-10.
- Valentine AR, Carvalho B, Lazo TA, Riley ET. Scheduled acetaminophen with as-needed opioids compared to as-needed acetaminophen plus opioids for post-cesarean pain management. Int J Obstet Anesth. 2015;24:210-6.
- Weiniger CF, Ezra Y, Dunn AL, Carvalho B. The utilization of spinal anesthesia for external cephalic version: a clinical practice cohort analysis. Int J Obstet Anesth. 2015;24:389-90.
- Wen L, Hilton G, Carvalho B. The impact of breastfeeding on maternal pain after vaginal and cesarean delivery. J Clin Anesth. 2015;27:33-8.
- Ahsan ZS, Carvalho B, Yao J. Incidence of failure of continuous peripheral nerve catheters for postoperative analgesia in upper extremity surgery. J Hand Surg Am. 2014;39:324-9.
- Austin N, Krishnamoorthy V, Dagal A. Airway management in cervical spine injury. Int J Crit Illn Inj Sci. 2014;4:50-6.
- Bateman BT, Tsen LT, Liu J, Butwick AJ, Huybrechts KF. Patterns of second-line uterotonic utilization in a large sample of delivery admissions in the United States. Anesth Analg. 2014;119:1344-9.
- Botto F, ... Sultan P, ... Wildes T. Vascular events in noncardiac surgery patients cohort evaluation (VISION) Writing Group. Myocardial Injury after noncardiac Surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes. Anesthesiology. 2014;120:564-78.
- Butwick AJ, Carvalho B, El-Sayed YY. Risk factors for severe obstetric morbidity in patients with uterine atony undergoing cesarean delivery. Br J Anaesth. 2014;113:661-8.
- Butwick AJ, Hass C, Wong J, Lyell D, El-Sayed Y. Retrospective study of peripartum and anesthetic outcomes in anticoagulated parturients. Int J Obstet Anesth. 2014;23:238-45.
- Caballero JA, Butwick AJ, Carvalho B, Riley ET. Preferred spoken language mediates differences in neuraxial labor analgesia utilization among racial and ethnic groups. Int J Obstet Anesth. 2014;23:161-7.
- Carvalho B. Strategies to optimize post-cesarean delivery analgesia. American Society of Anesthesiologists (ASA) refresher courses in anesthesiology. 2014 Volume 42.
- Carvalho B, Derby R, Horn JL. “Pseudo” shearing of a peripheral nerve catheter for interscalene block. Reg Anesth Pain Med. 2014;39:556-7.
- Carvalho B, Hilton G, Wen L, Weiniger CF. Prospective longitudinal cohort questionnaire assessment of laboring women's preference both pre- and post-delivery for either reduced pain intensity for a longer duration or greater pain intensity for a shorter duration. Br J Anaesth. 2014;113:468-73.
- Carvalho B, Zheng M, Aiono-Le Tagaloa L. A prospective observational study evaluating the ability of prelabor psychological tests to predict labor pain, epidural analgesic consumption, and maternal satisfaction. Anesth Analg. 2014;119:632-40.
- Cho Y, Carvalho B, Butwick A, Blumenfeld Y, Riley E. Elective caesarean section at 38 weeks versus 39 weeks: neonatal and maternal outcomes in a randomised controlled trial. BJOG. 2014;121:1748.
- Cierny JT, Unal ER, Flood P, Rhee KY, Praktish A, Olson TH, Goetzl L. Maternal inflammatory markers and term labor performance. Am J Obstet Gynecol. 2014;210;447.e1-6.
- D'Angelo R, Smiley RM, Riley ET, Segal S. Serious complications related to obstetric anesthesia: the serious complication repository project of the society for obstetric anesthesia and perinatology. Anesthesiology. 2014;120:1505-12.
- Daniels K, Oakeson A, Hilton G. Steps toward a national disaster plan for obstetrics. Obstet Gynecol. 2014;124:154-8.
- Ducloy-Bouthors AS, Susen S, Wong CA, Butwick A, Vallet B, Lockhart E. Medical advances in the treatment of postpartum hemorrhage. Anesth Analg. 2014;119:1140-7.
- 17. Elkomy MH, Sultan P, Drover DR, Ekaterina E, Galinkin JL, Carvalho B. Pharmacokinetics of prophylactic cefazolin in parturients undergoing cesarean delivery. Antimicrob Agents Chemother. 2014;58:3504-13.
- Flood P, Clark DJ. Genetic variability in the activity of monoamines: a window into the complexity of pain. Anesth Analg. 2014;119:1032-8.
- Flood P, Damaj MI. Nicotine is out: nicotinic agonists may have utility as analgesics. Anesth Analg. 2014;119:232-3.
- Flood P. Editorial commentary: "Progressive encephalomyelitis with rigidity and myoclonus: anesthesia and glycine receptor antibodies". A A Case Rep. 2014;2:86-7.
- Flood P, Raja SN. Balance in opioid prescription during pregnancy. Anesthesiology. 2014;120:163-4.
- Ickowicz DE, Golovanevski L, Domb AJ, Weiniger CF. Extended duration local anesthetic agent in a rat paw model. Int J Pharm. 2014;468:152-7.
- Ickowicz DE, Golovanevski L, Haze E, Domb AJ, Weiniger CF. Extended release local anesthetic agents in a postoperative arthritic pain model. J Pharm Sci. 2014;103:185-90.
- Ickowicz DE, Haim-Zada M, Abbas R, Touitou D, Nyska A, Golovanevski L, Weiniger CF, Katzhendler J, Domb AJ. Castor oil-citric acid co-polyester for tissue augmentation. Polym Adv Technol. 2014;25:SI1323-8.
- Kabiri D, Hants Y, Simons M, Shanwetter N, Weiniger CF, Gielchinsky Y, Ezra Y. Outcomes of subsequent pregnancies after conservative treatment for placenta accreta. Int J Gynaecol Obstet. 2014;127:206-10.
- Lipman S, Cohen S, Einav S, Jeejeebhoy F, Mhyre JM, Morrison LJ, Katz V, Tsen LC, Daniels K, Halamek LP, Suresh MS, Arafeh J, Gauthier D, Carvalho JC, Druzin M, Carvalho B. The Society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy. Anesth Analg. 2014;118:1003-16.
- Mariano ER, Yun RD, Kim TE, Carvalho B. Application of echogenic technology for catheters used in ultrasound-guided continuous peripheral nerve blocks. J Ultrasound Med. 2014;33:905-11.
- Peer L, Brezis ML, Shalit M, Carvalho B, Philip LD, Seri O, Weiniger CF. Evaluation of a prospectively administered written questionnaire to reduce the reported incidence of suspected latex anaphylaxis during elective cesarean delivery. Int J Obstet Anesth. 2014;23:335-40.
- Sharoni L, Weiniger CF. Anesthesia and external cephalic version. Curr Anesthesiol Rep. 2014;5:91-9.
- Soltanifer D, Afzal S, Harrison S, Sultan P. Caesarean delivery in a parturient with type III hereditary angioedema. Int J Obstet Anesth. 2014;23:398-9.
- Stocki D, Matot I, Einav S, Eventov-Friedman S, Ginosar Y, Weiniger CF. A randomized controlled trial of the efficacy and respiratory effects of patient-controlled intravenous remifentanil analgesia and patient-controlled epidural analgesia in laboring women. Anesth Analg. 2014;118:589-7.
- Sultan P, Edwards MR, Gutierrez Del Arroyo A, Cain D, Sneyd JR, Struthers R, Minto G, Ackland GL. Cardiopulmonary exercise capacity and preoperative markers of inflammation. Mediators Inflamm. 2014;2014:727451.
- Terkawi AS, Jackson, WM, Hansoti, S, Tabassum R, Flood P. Polymorphism in the ADRB2 gene explains a small portion of inter-subject variability in pain relative to cervical dilation in the first stage of labor. Anesthesiology. 2014;121:140-8.
- Udani A, Wang T, Hilton G, Harrison K. Physiology of pregnancy and postpartum hemorrhage: an innovative, interactive teaching approach. MedEdPORTAL Publications; 2014. Available from: https://www.mededportal.org/publication/9987.
- Weiniger CF, Carvalho B. The dilemma of vaginal breech delivery worldwide. Lancet. 2014;384:1183.
- Weiniger CF, Carvalho B. Analgesia following cesarean delivery: "Sometimes it takes a painful experience to make us change our ways" (proverbs 20:30). Isr Med Assoc J. 2014;16:171-2.
- Weiniger CF, Spencer PS, Weiss Y, Ginsberg G, Ezra Y. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving? Isr J Health Policy Res. 2014;3:5.