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  1. Article: Relationship between maternal arterial and foetal cord carbon dioxide tension and neonatal outcome in critically ill pregnant women at delivery.

    Scharf, Katelyn T / Bharadwaj, Shobana / Lankford, Allison / Wong, Michael / Kodali, Bhavani S

    Indian journal of anaesthesia

    2024  Volume 68, Issue 4, Page(s) 354–359

    Abstract: Background and aims: No studies have evaluated the relationship between maternal arterial partial pressure of carbon dioxide (mPaCO: Methods: Maternal and neonatal cord gas data at delivery and APGAR scores were obtained by a retrospective chart ... ...

    Abstract Background and aims: No studies have evaluated the relationship between maternal arterial partial pressure of carbon dioxide (mPaCO
    Methods: Maternal and neonatal cord gas data at delivery and APGAR scores were obtained by a retrospective chart review of 25 consecutive parturients with severe respiratory compromise who were delivered during mechanical ventilation. Linear regression was used to assess the relationship between mPaCO
    Results: There was a positive correlation between mPaCO
    Conclusion: Foetal cord venous PCO
    Language English
    Publishing date 2024-03-13
    Publishing country India
    Document type Journal Article
    ZDB-ID 412570-8
    ISSN 0019-5049
    ISSN 0019-5049
    DOI 10.4103/ija.ija_1218_23
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Foetal surgery: Anaesthetic implications and strategic management.

    Kodali, Bhavani Shankar / Bharadwaj, Shobana

    Indian journal of anaesthesia

    2018  Volume 62, Issue 9, Page(s) 717–723

    Abstract: Intrauterine surgery is being performed with increasing frequency. Correction of foetal ... ...

    Abstract Intrauterine surgery is being performed with increasing frequency. Correction of foetal anomalies
    Language English
    Publishing date 2018-09-20
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 412570-8
    ISSN 0019-5049
    ISSN 0019-5049
    DOI 10.4103/ija.IJA_551_18
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Not All Subarachnoid Hemorrhages in Pregnancy Are Intracranial in Origin: A Case Report.

    Kodali, Bhavani Shankar / Wong, Michael J / Galey, Jessica L / Bharadwaj, Shobana

    A&A practice

    2021  Volume 15, Issue 9, Page(s) e01521

    Abstract: Subarachnoid hemorrhage is uncommon in pregnancy and may be caused by intracranial aneurysms, arteriovenous malformations, venous thrombosis, or preeclampsia. We present an unusual case of subarachnoid hemorrhage in a term parturient where the bleeding ... ...

    Abstract Subarachnoid hemorrhage is uncommon in pregnancy and may be caused by intracranial aneurysms, arteriovenous malformations, venous thrombosis, or preeclampsia. We present an unusual case of subarachnoid hemorrhage in a term parturient where the bleeding originated from an extracranial source, namely a cervicothoracic arteriovenous malformation. This case highlights the challenge of diagnosing this condition when the initial presentation may be nonspecific, lacking in neurologic deficits, and confounded by the simultaneous presence of preeclampsia.
    Language English
    Publishing date 2021-09-15
    Publishing country United States
    Document type Journal Article
    ISSN 2575-3126
    ISSN (online) 2575-3126
    DOI 10.1213/XAA.0000000000001521
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Effect of Fetal Delivery on Pao2/Fio2 Ratio During Mechanical Ventilation in Parturients With COVID-19: A Case Series.

    Kodali, Bhavani Shankar / Wong, Michael J / Lankford, Allison / Lee, Khang / Bharadwaj, Shobana

    A&A practice

    2022  Volume 16, Issue 7, Page(s) e01587

    Abstract: It is controversial whether fetal delivery improves maternal oxygenation during mechanical ventilation. We evaluated maternal arterial partial pressure of oxygen (Pao2) to fractional oxygen concentration (Fio2) (P/F) ratios before and after delivery in ... ...

    Abstract It is controversial whether fetal delivery improves maternal oxygenation during mechanical ventilation. We evaluated maternal arterial partial pressure of oxygen (Pao2) to fractional oxygen concentration (Fio2) (P/F) ratios before and after delivery in this series of 15 parturients with coronavirus disease 2019 (COVID-19). Compared to the immediate postpartum period, P/F ratio was increased at 48 hours (212 ± 101 vs 271 ± 90; P = .006). Linear regression demonstrated improvement in P/F ratio during the study period (slope, 3.1; 95% confidence interval [CI], 0.87-5.34; P = .007), although predelivery and postdelivery periods separately did not exhibit any specific trend. Five patients required emergent bedside delivery. We discuss numerous considerations guiding delivery planning during mechanical ventilation.
    MeSH term(s) COVID-19/therapy ; Female ; Humans ; Lung ; Oxygen ; Respiration, Artificial ; Respiratory Distress Syndrome
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2022-07-25
    Publishing country United States
    Document type Journal Article
    ISSN 2575-3126
    ISSN (online) 2575-3126
    DOI 10.1213/XAA.0000000000001587
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Extracorporeal Membrane Oxygenation for Pregnant and Postpartum Patients.

    Wong, Michael J / Bharadwaj, Shobana / Galey, Jessica L / Lankford, Allison S / Galvagno, Samuel / Kodali, Bhavani Shankar

    Anesthesia and analgesia

    2022  Volume 135, Issue 2, Page(s) 277–289

    Abstract: Extracorporeal membrane oxygenation (ECMO) has seen increasing use for critically ill pregnant and postpartum patients over the past decade. Growing experience continues to demonstrate the feasibility of ECMO in obstetric patients and attest to its ... ...

    Abstract Extracorporeal membrane oxygenation (ECMO) has seen increasing use for critically ill pregnant and postpartum patients over the past decade. Growing experience continues to demonstrate the feasibility of ECMO in obstetric patients and attest to its favorable outcomes. However, the interaction of pregnancy physiology with ECMO life support requires careful planning and adaptation for success. Additionally, the maintenance of fetal oxygenation and perfusion is essential for safely continuing pregnancy during ECMO support. This review summarizes the considerations for use of ECMO in obstetric patients and how to address these concerns.
    MeSH term(s) Critical Illness ; Extracorporeal Membrane Oxygenation/adverse effects ; Female ; Humans ; Postpartum Period ; Pregnancy
    Language English
    Publishing date 2022-01-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000005861
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Peripartum Management in Myelodysplastic Syndrome Guided by Serial Thromboelastography: A Case Report.

    Karuppiah, Arunthevaraja / Galey, Jessica L / Bharadwaj, Shobana / Elsamadicy, Emad A / Kodali, Bhavani Shankar

    A&A practice

    2021  Volume 15, Issue 3, Page(s) e01403

    Abstract: Myelodysplastic syndrome with severe thrombocytopenia is a rare disease in women of child-bearing age. The challenging aspect in management of such a patient is maintaining optimal coagulation with minimum platelet transfusion during the peripartum ... ...

    Abstract Myelodysplastic syndrome with severe thrombocytopenia is a rare disease in women of child-bearing age. The challenging aspect in management of such a patient is maintaining optimal coagulation with minimum platelet transfusion during the peripartum period. Multiple transfusions can result in allo-sensitization which can affect lifesaving bone marrow transplantation in future. Thromboelastography is a useful tool to assess and guide appropriate transfusion requirements.
    MeSH term(s) Female ; Humans ; Myelodysplastic Syndromes/therapy ; Peripartum Period ; Platelet Transfusion ; Thrombelastography ; Thrombocytopenia
    Language English
    Publishing date 2021-03-15
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2575-3126
    ISSN (online) 2575-3126
    DOI 10.1213/XAA.0000000000001403
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Efficacy of sonorheometry point of the care device in determining low fibrinogen levels in pregnant blood: an invitro dilution and reconstitution study.

    Kodali, Bhavani Shankar / Karuppiah, Arun / Bharadwaj, Shobana / Chow, Jonathan / Tanaka, Kenichi

    Journal of clinical monitoring and computing

    2021  Volume 36, Issue 5, Page(s) 1423–1431

    Abstract: Quantra® Hemostasis Analyzer is a Point of the care device that uses ultrasound technology to assess clot formation. In this study, we establish how Quantra® system performs compared to conventional coagulation tests at low levels of fibrinogen in the ... ...

    Abstract Quantra® Hemostasis Analyzer is a Point of the care device that uses ultrasound technology to assess clot formation. In this study, we establish how Quantra® system performs compared to conventional coagulation tests at low levels of fibrinogen in the blood obtained from pregnant women. 24 mL blood was obtained from each healthy parturient. Blood was analyzed for Quantra® variables (Q): Clot time (CT), Clot stiffness (CS), platelet contribution to CS (PCS), fibrinogen contribution to CS (FCS), and conventional coagulation (CL) tests: PT, aPTT, INR, Factor VIII and fibrinogen. 6 ml blood were centrifuged to obtain pregnant plasma. 30 mL of saline was added to 10 mL of blood to simulate crystalloid resuscitation (DB) and was evaluated for Q and CL. Fractions of pregnant plasma, or nonpregnant plasma (Blood Bank) was added to DB to obtain 15% and 30% clotting factor enriched samples. 4 ml of DB was added to 4 ml of original blood (1:1) to obtain the final sample (resus). Each of the samples were analyzed for Q and CL parameters. Regression analysis and Receiving Characteristics Curves were used to study the relationship between Quantra variables and CL tests. There were remarkably high linear correlations between Fibrinogen and CS (R = 0.93, P < 0.001), fibrinogen and FCS (R = 0.77, P < 0.001). An FCS value 2.45 (sensitivity of 79.2 and specificity of 97.3%), and CS value 10.85 hPa (sensitivity of 83% and specificity of 100%) predicted fibrinogen of 200 mg/dL. This study demonstrates a good correlation between Quantra® CS, FCS and serum fibrinogen.Clinical Trial Number: NCT04301193.
    MeSH term(s) Blood Coagulation Factors ; Crystalloid Solutions ; Factor VIII ; Female ; Fibrinogen/analysis ; Humans ; Monitoring, Intraoperative ; Pregnancy ; Thrombelastography
    Chemical Substances Blood Coagulation Factors ; Crystalloid Solutions ; Factor VIII (9001-27-8) ; Fibrinogen (9001-32-5)
    Language English
    Publishing date 2021-12-03
    Publishing country Netherlands
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1418733-4
    ISSN 1573-2614 ; 1387-1307 ; 0748-1977
    ISSN (online) 1573-2614
    ISSN 1387-1307 ; 0748-1977
    DOI 10.1007/s10877-021-00782-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Adaptation of labor and delivery to COVID-19.

    Karuppiah, Arunthevaraja / Bharadwaj, Shobana / Crimmins, Sarah / Elsamadicy, Emad / Rabin, Joseph / Kodali, Bhavani Shankar

    American journal of disaster medicine

    2020  Volume 15, Issue 2, Page(s) 93–97

    Abstract: As the novel coronavirus disease (COVID-19) escalates globally, and no end in sight, we describe an approach for adapting swiftly to the increasing number of COVID-19 parturients admitted into labor and delivery unit. The adaptability includes physical ... ...

    Abstract As the novel coronavirus disease (COVID-19) escalates globally, and no end in sight, we describe an approach for adapting swiftly to the increasing number of COVID-19 parturients admitted into labor and delivery unit. The adaptability includes physical layout, triaging, quick testing, isolating confirmed parturients, access to designated intensive care units, facilitating emergent cesarean deliveries, and educating health care personnel. It is vital that other healthy parturi-ents and healthcare providers must be protected from COVID-19. It is encouraged that institutions exchange and dis-seminate information to succeed in the global fight against this dreaded pandemic.
    MeSH term(s) Adult ; Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Delivery, Obstetric ; Female ; Humans ; Infection Control/methods ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Labor, Obstetric ; Male ; Middle Aged ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pregnancy ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-08-03
    Publishing country United States
    Document type Journal Article
    ISSN 1932-149X
    ISSN 1932-149X
    DOI 10.5055/ajdm.2020.0359
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Surgical advances in the management of placenta accreta spectrum: establishing new expectations for operative blood loss.

    Cojocaru, Liviu / Lankford, Allison / Galey, Jessica / Bharadwaj, Shobana / Kodali, Bhavani S / Kennedy, Kelly / Goetzinger, Katherine / Turan, Ozhan M

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2020  Volume 35, Issue 23, Page(s) 4496–4505

    Abstract: Objective: To evaluate whether the implementation of our surgical approach, referred to in the text as Linear Cutter Vessel Sealing System (LCVSS) technique, will improve perioperative outcomes in patients with placenta accreta spectrum (PAS), ... ...

    Abstract Objective: To evaluate whether the implementation of our surgical approach, referred to in the text as Linear Cutter Vessel Sealing System (LCVSS) technique, will improve perioperative outcomes in patients with placenta accreta spectrum (PAS), specifically by reducing blood loss and blood transfusion rates at the time of cesarean hysterectomy (C-HYST). The LCVSS technique integrates the following: (1) hysterotomy performed using the Linear Cutter, (2) no placental manipulation, (3) cauterization of anatomically prominent vascular anastomosis using the handheld vessel sealing system, and (4) completion of bladder dissection until the cervico-vaginal junction before ligation and division of uterine arteries.
    Materials and methods: This is a retrospective cohort study that analyzed perioperative outcomes in patients undergoing C-HYST for PAS at a tertiary care center from 1 July 2014 to 1 December 2019. Comparisons were performed between cases managed with the use of the LCVSS technique (designated as LCVSS cohort) and those managed without the use of the LCVSS technique (designated as no technique cohort). The primary outcomes were cumulative blood loss (CBL) and total perioperative blood transfusion of ≥4 and ≥6 units of PRBCs. The secondary outcomes were intra- and postoperative complications. Continuous and categorical variables were compared according to the sample size and distribution. Binary logistic regression analysis was performed to predict confounders for blood transfusion of ≥4 units of PRBCs.
    Results: A total of 69 prenatally diagnosed PAS cases underwent C-HYST at the time of delivery. Forty-four cases that were performed using the LCVSS technique comprised the LCVSS cohort. The remaining 25 were marked as no technique cohort. CBL was significantly lower in the LCVSS cohort (1124 ml [300-4100] vs 3500 ml [650-10600];
    Conclusion: Implementation of this advanced surgical approach for PAS management resulted in reduced blood loss and blood transfusion rates in comparison with no technique cohort.
    MeSH term(s) Blood Loss, Surgical/prevention & control ; Female ; Humans ; Hysterectomy/methods ; Infant, Newborn ; Motivation ; Placenta Accreta/surgery ; Postoperative Complications/surgery ; Pregnancy ; Retrospective Studies
    Language English
    Publishing date 2020-12-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.1080/14767058.2020.1852213
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Adaptation of labor and delivery to COVID-19

    Karuppiah, Arunthevaraja / Bharadwaj, Shobana / Crimmins, Sarah / Elsamadicy, Emad / Rabin, Joseph / Kodali, Bhavani Shankar

    Am J Disaster Med

    Abstract: As the novel coronavirus disease (COVID-19) escalates globally, and no end in sight, we describe an approach for adapting swiftly to the increasing number of COVID-19 parturients admitted into labor and delivery unit. The adaptability includes physical ... ...

    Abstract As the novel coronavirus disease (COVID-19) escalates globally, and no end in sight, we describe an approach for adapting swiftly to the increasing number of COVID-19 parturients admitted into labor and delivery unit. The adaptability includes physical layout, triaging, quick testing, isolating confirmed parturients, access to designated intensive care units, facilitating emergent cesarean deliveries, and educating health care personnel. It is vital that other healthy parturi-ents and healthcare providers must be protected from COVID-19. It is encouraged that institutions exchange and dis-seminate information to succeed in the global fight against this dreaded pandemic.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #721604
    Database COVID19

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