Related Experiment Video
Updated: Feb 13, 2026
06:38
Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity AIDN: A Translational Neuroscience Approach
Published on: June 11, 2017
11.7K
Anesthetic approaches for malpresentation and multiple gestation
Oscar F C van den Bosch1, Feline F J A Ter Bruggen1, Erica M Johnson2
1Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Current Opinion in Anaesthesiology
|February 12, 2026
Summary
Anesthesiologists should be prepared for external cephalic version (ECV) and labor analgesia in malpresentation and multiple gestation. Cesarean delivery in multiple gestations increases postpartum hemorrhage risk, requiring vigilant care.
Area of Science:
- Obstetrics and Anesthesiology
- Maternal-Fetal Medicine
Background:
- Malpresentation and multiple gestation present unique anesthetic challenges.
- Current anesthetic practices require updates based on recent evidence.
Purpose of the Study:
- To review anesthetic considerations for malpresentation and multiple gestation.
- To cover analgesia for external cephalic version (ECV), labor, and cesarean delivery.
- To discuss postpartum hemorrhage risk management.
Main Methods:
- Literature review of anesthetic management in malpresentation and multiple gestation.
- Analysis of recent findings on neuraxial analgesia and cesarean delivery risks.
Main Results:
- Neuraxial analgesia enhances ECV success and maternal comfort.
- Neuraxial labor analgesia improves safety in multiple gestation vaginal deliveries.
- Cesarean delivery in multiple gestations has a higher risk of uterine atony and increased oxytocin needs.
Conclusions:
- Anesthesiologists must be vigilant for malpresentation and multiple gestation cases.
- Gaps between evidence and practice necessitate implementation studies and guidelines.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
5.1K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
5.1K
01:13Local Anesthetics: Pharmacokinetics
1.2K
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
1.2K
01:20Inhalational Anesthetics: Overview
1.2K
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
1.2K
01:24Parenteral Anesthetics: Overview
772
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
772
01:49Multiple Allele Traits
38.2K
The Concept of Multiple Allelism
38.2K
01:23Local Anesthetics: Mechanism of Action
3.4K
Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...
3.4K