Simon Ash Profile picture
Nov 8, 2022 9 tweets 11 min read Read on X
Prof Marie Pierre Bonnet = @MariePierreBon2 (yay! for #SoMe) and she presents on anemia in #ObAnes at #OAA3dc2022 (photo better than podium ones). Definition of anemia in pregnancy: 110 or greater (11.0g/dL). Worldwide disparities. ImageImageImageImage
Iron deficiency dominates anemia in pregnancy. Iron deficiency is innocuous, right? Perhaps not in pregnancy. Maternal iron deficiency affects more than just Hb. It is associated with adverse outcomes. #OAA3dc2022 ImageImageImageImage
@MariePierreBon2 highlights anemia’s impact on maternal mortality (@BJOGTweets @mbrrace): aOR 3.6! Not just mortality, but morbidity burden as well (@Anaes_Journal). The psychological impact of maternal anemia is acknowledged - postpartum depression & cognition #OAA3dc2022 ImageImageImageImage
Systematic prevention of anemia in pregnancy is difficult - poor consensus, wide variation. @NICEComms dropped iron supplementation in 2021 update. No consensus from USA: @CDCgov recommends in 1998, lost in 2015, back in @acog recommendations 2021 - low dose iron
#OAA3dc2022 ImageImageImage
@cochranecollab 2015 found poor evidence for iron supplementation routinely. @NATAforum recommendations 2019 focused on population factors: supplement routinely if high risk, test ferretin if not. @cochranecollab found intermittent iron supplementation viable #OAA3dc2022 ImageImageImage
Curative treatment - is it possible? Oral or IV? Both have pro’s and con’s. IV iron may be superior, but does it impact on clinical outcomes? #OAA3dc2022 ImageImageImage
IV iron definitely impacts anemia at delivery more than oral iron, but no difference in birth weight, gestational age or umbilical Hb (@BMJ_Open). IV did improve quality of life at 4 weeks after starting treatment. #OAA3dc2022 ImageImage
As Peri-delivery physicians who may encounter #OBAnes patients during their pregnancy, we should possibly ensure treatment of anemia? @MariePierreBon2 recommends an algorithmic approach. #OAA3dc2022 Image
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More from @OBsleepmerchant

May 9
@SQuashie presents an update on anesthesia for operative delivery. Declarations. Methodology and themes. #OAA24ASM #OBAnes

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Gastric USS. Oral rehydration has benefits over NPO wrt vasopressor use. #siptilsend safe, noting some patients have increased gastric volumes irrespective of starvation status. #OAA24ASM #OBAnes
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@SQuashie continues at a rapid pace. To DPE or not to DPE remains a question - 16min vs 19 min, is that 3 min clinically relevant? Esketamine for supplemental analgesia - >95% had psych effects, read @rjharrison79 editorial. #OAA24ASM #OBAnes
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Read 16 tweets
May 9
@Jamesocarroll presents an Update on Labour and Delivery. Disclosures #OAA24ASM #OBAnes

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How the lecture was put together. Screening. Themes. How to interpret the slides. Very Ostheimer-esque @Jamesocarroll #OAA24ASM #OBAnes


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@Jamesocarroll Clinical practice theme: intrathecal catheters & ADP. Intrathecal catheters: No decrease in PDPH, but reduction in EBP. 10mL intrathecal saline decreased PDPH & need for EBP. Of note, the percentage of epidurals requiring multiple attempts. #OAA24ASM #OBAnes

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Read 17 tweets
May 5
8am-ish in Denver and time for a much anticipated session: PDPH beyond the guidelines. Moderated by Dr Lisa Leffert, featuring @Ropivacaine, @euklaas, @sharonOzynger and @WouterSchievink at #SOAPAM2024 #OBAnes

(HT: @Ropivacaine, bless his heart, he knows I hate missing out)

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Hot off the Press? August 2023! @JAMANetworkOpen with quite an illustrious team including @Ropivacaine @robin_russell1 @KalagaraHari @LimGrapes @claralexlobo @noolslucas @NarouzeMD (please tag others if you have their handles?) #SOAPAM2024 #OBAnes

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Introduction, Methods and the 10 questions. #SOAPAM2024 #OBAnes

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Read 11 tweets
Jun 12, 2023
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
Jun 11, 2023
Dr Ning Nan Wang introduces @harshamd5 to open the chronic pain session: Perioperative use of opioid in the context of Opioid Epidemic. #CASAM2023 ImageImageImage
The opioid crisis isn’t new - China probably remembers the Opium wars that helped establish a British foothold on the continent. Opioids and OUR crisis. Is what we fear the real crisis? Are opioid-related deaths due to surgical prescriptions? No, mostly due to street fentanyl.… twitter.com/i/web/status/1… ImageImageImage
Opioid use around the time of surgery. Understanding nociception vs pain. Does eliminating opioids during surgery make a difference - no definitive conclusions. #CASAM2023 ImageImageImage
Read 11 tweets
Jun 10, 2023
@DrLucieFilteau introduces @CMA_Docs president @AlikaMD for his keynote address at #CASAM2023 Image
@AlikaMD starts with the state of the 🇨🇦 health system, including a little history. #CASAM2023 ImageImage
The 🇨🇦 health system approach to problems, creating new problems as a result with a dangerous lack of interoperability. #CASAM2023 ImageImageImage
Read 12 tweets

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