Discover and read the best of Twitter Threads about #OBanes

Most recents (24)

Next up at #CASAM2023 - fittingly keeping the most important academic session to last: #OBAnes
@ValZaph moderating the Maternal Experience and Outcomes: Improving the care we provide. @DrWesleyEdwards

Bookends the 1st #OBAnes session, on intrapartum pain at cesarean section… twitter.com/i/web/status/1… Image
Dr Christina Lamontagne kicks off the session with: Use of Dexmedetomidine in improving maternal experience and outcomes. Nothing to disclose. Then an important disclosure: All indications discussed are OFF LABEL in Canada. Objectives.
#OBAnes #CASAM2023 ImageImageImageImage
Why does Dr Lamontagne use a lot of dexmedetomidine (not only in #OBAnes mind)? Clinical pharmacology of dexmedetomidine (1): highly selective alpha-2 agonist; sedation WITHOUT amnesia at locus coeruleus. #CASAM2023 ImageImageImage
Read 9 tweets
Up next: @ValZaph moderates the #OBAnes session on PPH: a focus on coagulation. Dr Karine Doyon and @LorrainechowMD presenting. #CASAM2023 Image
PPH: a focus on coagulation is kicked off by Dr Karine Doyon (a hematologist). Objectives. Canada ranked 39th in world in maternal mortality - not sure if that’s good. We’re doing better than USA. #OBAnes #CASAM2023 ImageImageImage
Causes of coagulopathy in pregnancy - Dr Doyon won’t be discussing inherited disorders. The focus will be on the acquired hemorrhagic disorders. #OBAnes #CASAM2023 ImageImage
Read 20 tweets
@DrWesleyEdwards chair of @CAS_OBSection introduces the first #OBAnes session of #CASAM2023.
Speakers: @SusannaStanford @ammunro2 @Ropivacaine Image
@SusannaStanford starts off with the importance of having a talk with the word “failure” in it. #OBAnes #CASAM2023 ImageImage
I have not asked permission to share @SusannaStanford’s whole lecture video today, and it’s 20minutes long. However, see the following links:

oaawebcast.info/susanna

#OBAnes #CASAM2023
Read 29 tweets
Novel Content No.2 at #SOAPAM2023 virtual #OBAnes highlights Day 2: @DoctorStahl speaks on Obstetric Critical Care #OBCritCare ImageImage
@DoctorStahl is an intensive care bear, who loves #OBAnes. QR code to references. #OBCritCare #SOAPAM2023 ImageImageImage
Pregnancy-associated mortality ≈ maternal mortality. #OBAnes 0.2% - doing well (wonder what the denominator is?), so Elmo could ask why are we worried? #SOAPAM2023 ImageImageImage
Read 35 tweets
@matmedicine presents the first NOVEL content session of #SOAPAM2023 virtual #OBAnes highlights: Trauma in Pregnancy for the Non-Obstetric Provider. Objectives. Goals. All live from Italy - somewhat jealous @matmedicine ImageImageImage
Physiological changes during pregnancy (1): Cardiac/ hemodynamic changes. Haematological changes. Are these protective? #OBAnes #SOAPAM2023 ImageImage
Physiological changes during pregnancy (2): Respiratory effects - displacement of diaphragm is key? ABG changes important - lactate the same in pregnant and non-pregnant @matmedicine? #OBAnes #SOAPAM2023 ImageImageImage
Read 18 tweets
#SolShnider track 3 during #SOAPAM2023 virtual #OBAnes highlights Day 2 kicks off with @antonchau1 on DPE vs other LEA options.
Dr Mark Zakowski, MD presents on Barriers to optimal staffing in #OBAnes (topical for @OAAinfo, @SOAPHQ & @CAS_OBSection members - indeed the worldwide shortage of #AnyAnes makes this important for @wfsaorg @ASALifeline @ANZCA @docanaesthetic @CASUpdate) #SOAPAM2023. “Adapt or… twitter.com/i/web/status/1… ImageImageImageImage
Read 15 tweets
@JenDominguezMD kicks off first session of #SOAPAM2023 virtual #OBAnes highlights Day 2 with the best case reports. Learning objectives. #SoMe embargo on content (@AnaSjaus ahem). Divided into 4 topics. ImageImageImageImage
Distinguished judges! Image
Cardiac: 2 cases of PHTN in #OBAnes - interesting cases, here are the allowed #SoMe slides. ImageImage
Read 6 tweets
Back to #SOAPAM2023 virtual #OBAnes highlights with the #Solshnider track 1
@SparklesSpinals then proceeded to speak on opioids in pregnancy and beyond #OBAnes
Read 4 tweets
Just off great @dasairway @OAAinfo #OBAnes airway masterclass webinar with @silv24 chairing, @ProfEllenO @noolslucas @Chakladar_A and @DesireOnwochei giving expert opinions - lots of notes taken, tweets to follow twitter.com/i/web/status/1… Image
Right, let’s get to it. The #OBAnes airway - shifting the paradigm; a @dasairway & @OAAinfo masterclass. Two Profs in the corner… this should be interesting. @noolslucas kicks off the webinar. Image
What is a difficult airway? @ASALifeline definition: a clinical situation, conventionally trained anesthesiologist, difficult face mask ventilation/ intubation/ both.

Complications - hypoxemia: @MariePierreBon2 et al @BJAJournals 2020, @DavidGray37 @rosshofmeyr and co, SAJAA… twitter.com/i/web/status/1… ImageImageImageImage
Read 38 tweets
@rr_metabolicmed presents the Bruce Scott Lecture 2023 at #OAA23ASM: Obesity & diabetes in pregnancy - legacy for the child. #OBAnes Image
Study of 1.3 million pregnant women reveals global obesity crisis: 75% pregnant women fail to achieve healthy weight gain during pregnancy, leading to preventable adverse health consequences for both the women and their babies. Obesity has strong evidence for increased risk of… twitter.com/i/web/status/1… ImageImageImage
Maternal obesity and offspring cardiovascular disease: maternal obesity increases offspring cardiovascular death (Hazard ratio [all cause mortality] = 1.35). At current UK maternal obesity rates, this equates to extra 650 deaths before age 50 each year. The Hazard ratio for type… twitter.com/i/web/status/1… ImageImageImage
Read 14 tweets
@TasPirani presents of Liver disease in pregnancy. A lot to cover! #OBAnes #OAA23ASM ImageImage
Physiological changes in pregnancy. Normal LFT/ laboratory changes. #OBAnes #OAA23ASM ImageImage
Causes of liver derangement in pregnancy: flare of pre-existing liver disease (known or unknown). Incidence of pregnancy in people with chronic liver disease at King’s College Hospital. Historically, cirrhotic patients have been infertile d/t anovulation. Population based data… twitter.com/i/web/status/1… ImageImageImageImage
Read 18 tweets
@ICULone presents on Severe Maternal Morbidity (SMM) and its consequences at #OAA23ASM. #OBAnes Image
Definition of acute SMM: severe, life threatening event during pregnancy & within 6 weeks of delivery. @NPEU_UKOSS provides UK wide high quality obstetric surveillance. Deaths, while uncommon, investigated in depth.

Study Aims: operationalise definition of SMM; report incidence… twitter.com/i/web/status/1… ImageImageImage
SMM at a population level. Study population derivation. #OBAnes #OAA23ASM ImageImage
Read 11 tweets
Prof Donald Peebles on Embedding Maternal Medicine Networks at #OAA23ASM. Knowing who to call is half the solution to any problem? (Touched on by @elsmere_g during #OBAnes session at #Anaesthesia2023) Image
Direct maternal mortality rate per 100,000 maternities had been decreasing over the last 2 decades, but should a remarkable upswing since 2018, not all accounted for by #COVID19. @mbrrace outlined a case for change: most parts of UK have MDT, but make up variable most without… twitter.com/i/web/status/1… ImageImage
The Maternal Medicine Network (MMN) mandate: ensure timely access to specialist advice and care at all stages of pregnancy. Development of Maternal Medicine specialist centres as regional hub & spoke model = urgent national priority (@DOckendenLtd report)

MMN Ambition and… twitter.com/i/web/status/1… ImageImage
Read 5 tweets
Dr Katy Sheehan and @ArcBroom present the pick of the posters at #OAA23ASM. 4 criteria for selection of #OBAnes abstracts. ImageImage
A positive start, with the power of positive communication on patient satisfaction, morale & culture, and #patientsafety #OBAnes #OAA23ASM ImageImageImageImage
Barriers to care. Ethnicity, Language and Socioeconomic deprivation. @mbrrace, @TheLancet, and most recently @Anaes_Journal (@LateralTilt @noolslucas @SQuashie @Marianfknight) set the stage. #OBAnes #OAA23ASM ImageImageImageImage
Read 18 tweets
@NoelleHealy (another 🇮🇪 representative - @ISOA_Ireland well represented!) presents on #OBAnes as a team sport - how do we perform better? at #OAA23ASM. Quite an inspiring quote, then setting the stage with @Fionafionakel et al #humanfactors guidelines in @Anaes_Journaltwitter.com/i/web/status/1… ImageImageImage
Why is teamwork important in OB/ #OBAnes? @mbrrace suggests some lessons to be learned. Prompt action is arguably reliant on good communication, within & between teams. Involving consultant/ specialist care early has been a theme for over a decade. #OAA23ASM ImageImageImage
@DOckendenLtd’ final report highlighted “conflicting agendas and poor teamwork” contribute to adverse maternal & neonatal outcomes? So how do we create good teams?

The @JulieAndrews approach may have the hills alive, but for #OBAnes we may need to start at the very beginning,… twitter.com/i/web/status/1… ImageImage
Read 10 tweets
@emirakur presents an update on @NAPs_RCoA NAP7 Perioperative cardiac arrest & #OBAnes at #OAA23ASM. ImageImage
The history of @NAPs_RCoA projects and key findings for #OBAnes over the years (failed intubation NAP4 1:390, recent US data 1:808 - gotten better or different methodology?) #OAA23ASM ImageImage
Cardiac arrest in pregnancy. CAPS study @BJOGTweets (I see @Marianfknight?) looked at incidence, management & outcomes in UK. #OBAnes have a significant slice of the pie. @SOAPHQ serious complication repository project (incl. @RichSmileyMD @bscottsegal) provide US data: cardiac… twitter.com/i/web/status/1… ImageImageImageImage
Read 11 tweets
@Rose_Kearsley (@RotundaHospital - my fellowship alma mater) speaks on #OBAnes in the 4th trimester at #OAA23ASM. ImageImage
At the outset, @Rose_Kearsley addresses the definition of trimester (3 months, not only “a third of”). It’s not a novel concept - in lay, academic and anesthesia literature - which makes sense when one thinks of how many pregnancy-associated disease extend beyond delivery (not… twitter.com/i/web/status/1… ImageImageImageImage
#OBAnes workload. 33.3% time on procedures. NB average workload does NOT reflect ebbs & flows, more so surges of activity. @NAPs_RCoA NAP7 data: majority of labour analgesia 1800-0800; #OBAnes accounts for majority of single speciality #AnyAnes work 1800-0800; increasing obesity… twitter.com/i/web/status/1… ImageImageImageImage
Read 10 tweets
@LimGrapes continues her tour de force at #OAA23ASM with Decision Making and Neuraxial Anesthesia. New evidence around thrombocytopenia and how those guidelines affect decision making in #OBAnes ImageImage
To start: a Case. Possible evolving HELLP. Trends are important. Discuss anesthesia options.
#OBAnes #OAA23ASM ImageImageImageImage
Defining the problem: preeclampsia itself results in qualitative platelet dysfunction (even before HELLP). Preeclampsia has circulating microthrombi. Platelets are pre-activated, proaggregatory and prothrombotic BUT don’t respond to exposed collagen —> perioperative bleeding… twitter.com/i/web/status/1… ImageImageImageImage
Read 15 tweets
@AliciaTDennis starts day 2 of #OAA23ASM with an update on the management of preeclampsia. #OBAnes ImageImage
The problem of preeclampsia and maternal morbidity & mortality is not new (1933 - 33.3% with eclampsia DIED) Nor is it a UK/ US problem. #OBAnes #OAA23ASM ImageImage
Cardiac disease and preeclampsia feature as leading causes of maternal mortality in @mbrrace reports. Complications of preeclampsia are multiple. Preeclampsia and heart disease are included in key messaging. It’s a @WHO problem: international comparisons. #OBAnes #OAA23ASM ImageImageImageImage
Read 13 tweets
ERAC at #OAA23ASM, expertly managed by #OBAnes @LimGrapes from @OBAnesUPMC Image
@LimGrapes lays out the objectives of her talk and highlights the model for improvement applicable to #AnyAnes. Great quote! #OBAnes #OAA23ASM ImageImage
What is ERAC? Well, let’s start at the very beginning (seems like a good place to start): enhanced recovery is about quicker recovery and improving outcomes. Most of all it is an APPROACH! #OBAnes #OAA23ASM ImageImageImage
Read 14 tweets
@DevroeSarah presents on Anaesthesia in Pregnancy and Neurodevelopment at #OAA23ASM. Quite an outline! #OBAnes ImageImage
@DevroeSarah begins with epidemiology - 0.4-1% pregnant women will have non-OB surgery during their pregnancy. Fetus = innocent bystander. Complicated question. What is the pathobiology of normal brain development? Is there a link between anaesthesia and impaired brain… twitter.com/i/web/status/1… ImageImageImageImage
Mechanisms? Drug-induced vs multifactorial. Preclinical evidence of consistent association. Clinical evidence inconclusive. Preclinical findings certainly headline grabbing, which prompted a systematic review and meta-analysis from Bleeser et al (incl. @DevroeSarah @rex_steffentwitter.com/i/web/status/1… ImageImageImageImage
Read 10 tweets
@RopeyP: it’s good to talk - multispeciality decision-making for the pregnant patient having urgent non-OB surgery. SLIDO. Disclosures - #OBAnes is quite welcoming though. #OAA23ASM ImageImageImage
Some more background for case-based discussion. Aims of anaesthesia when there’s more than 1 patient. Planning for surgery isn’t “big syringe, little syringe”. What are the patient’s priorities? Do ours align? #OBAnes #OAA23ASM ImageImageImageImage
Multiple disciplines feeding into patient experience and decision making. She has indications for surgery - don’t delay. Management options (BRAN) - laparoscopic subtotal colectomy. #OBAnes #OAA23ASM ImageImageImage
Read 7 tweets
@rjharrison79 opens #OAA23ASM with an update on Labour Analgesia for 2023. Sir James Young Simpson remembered. ImageImage
It reads like an #Ostheimer - @rjharrison79 may be a contender to fill @PervezSultanMD’s shoes? Love the QR codes! #OBAnes at #OAA23ASM has gone state of the art! ImageImage
Analgesia efficacy: to puncture or not to puncture, that may be the question. (Puncture and give something or not?) #DPE studies on surgical onset times required, worrying signal regarding PDPH?#OBAnes #OAA23ASM ImageImageImage
Read 14 tweets
Dr Neel Desai provides an Update on Anesthesia for Cesarean Delivery at #OAA23ASM #OBAnes Image
Starting with the mainstays: choice of local anaesthetic and intrathecal morphine. Prilocaine 2% has compared favourably with bupivacaine 0.5%. However, there are caveats: if prilocaine is to be considered for routine #OBAnes it is recommended a CSE be used. ITM does NOT prevent… twitter.com/i/web/status/1… ImageImageImage
The very topical: inadequate neuraxial anaesthesia for cesarean section. See lectures from @hnixon147 and @PervezSultanMD from recent @SOAPHQ annual meeting elsewhere on my timeline - this is a widespread concern. @Jamesocarroll has initiated a large multicentre trial through the… twitter.com/i/web/status/1… ImageImageImage
Read 11 tweets

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