2021
Labor prior to cesarean delivery associated with higher post-discharge opioid consumption
Ende HB, Landau R, Cole NM, Burns SM, Bateman BT, Bauer ME, Booth JL, Flood P, Leffert LR, Houle TT, Tsen LC. Labor prior to cesarean delivery associated with higher post-discharge opioid consumption. PLOS ONE 2021, 16: e0253990. PMID: 34242277, PMCID: PMC8270408, DOI: 10.1371/journal.pone.0253990.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidCesarean SectionFemaleHumansLabor, ObstetricPain, PostoperativePatient DischargePregnancyTabletsConceptsDay of surgeryPostoperative pain scoresPain scoresOpioid utilizationOpioid useSurgical proceduresTime pointsHigher postoperative pain scoresPost-cesarean delivery painPost-discharge opioid consumptionAcute post-operative painComplications of CDMaximal pain scoresPost-cesarean analgesiaProspective cohort studyPost-operative painAdditional surgical proceduresNumeric rating scaleIdentification of womenAcademic medical centerNumber of tabletsSet of confoundersPhone two weeksOpioid consumptionOpioid requirementsThe Society for Obstetric Anesthesia and Perinatology Coronavirus Disease 2019 Registry: An Analysis of Outcomes Among Pregnant Women Delivering During the Initial Severe Acute Respiratory Syndrome Coronavirus-2 Outbreak in the United States
Katz D, Bateman BT, Kjaer K, Turner DP, Spence NZ, Habib AS, George RB, Toledano RD, Grant G, Madden HE, Butwick AJ, Lynde G, Minehart RD, Beilin Y, Houle TT, Sharpe EE, Kodali B, Bharadwaj S, Farber MK, Palanisamy A, Prabhu M, Gonzales NY, Landau R, Leffert L. The Society for Obstetric Anesthesia and Perinatology Coronavirus Disease 2019 Registry: An Analysis of Outcomes Among Pregnant Women Delivering During the Initial Severe Acute Respiratory Syndrome Coronavirus-2 Outbreak in the United States. Anesthesia & Analgesia 2021, 133: 462-473. PMID: 33830956, DOI: 10.1213/ane.0000000000005592.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesia, ObstetricalAnesthesia, GeneralAnesthesia, ObstetricalCase-Control StudiesCesarean SectionCOVID-19Delivery, ObstetricFemaleGestational AgeHumansInfant, PrematurePregnancyPregnancy Complications, InfectiousPremature BirthRegistriesRisk AssessmentRisk FactorsUnited StatesYoung AdultConceptsSARS-CoV-2 patientsSARS-CoV-2 infectionWeeks of gestationCesarean deliveryObstetric anesthesiaPositive SARS-CoV-2 polymerase chain reaction testSARS-CoV-2 polymerase chain reaction testAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionSARS-CoV-2-infected patientsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreakSyndrome coronavirus 2 infectionMaternal respiratory failureAdverse pregnancy outcomesCoronavirus 2 infectionNeuraxial labor analgesiaUS cohort studyDays of deliveryUS medical centersPolymerase chain reaction testComposite outcome measureAnalysis of outcomesChain reaction testPeripartum outcomesAsymptomatic patients
2020
Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system
Walsh E, Zhang Y, Madden H, Lehrich J, Leffert L. Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system. Regional Anesthesia & Pain Medicine 2020, 46: 258-267. PMID: 33115718, DOI: 10.1136/rapm-2020-101792.Peer-Reviewed Original ResearchConceptsNeuraxial anesthesiaObstetric patientsSpinal cordCesarean delivery anesthesiaCesarean deliveryLabor analgesiaNeuraxial analgesiaVertebral columnCase seriesGeneral anesthesiaObstetrical patientsRetrospective studyDelivery anesthesiaPatient injuryAnesthesiaPatient harmPatientsNarrative reviewAvailable evidenceUnwarranted fearsNeuromuscular systemAdditional riskPresent unique challengesAnalgesiaCord
2018
Implementation of a Quality Improvement Initiative to Decrease Opioid Prescribing After Cesarean Delivery
Prabhu M, Dubois H, James K, Leffert LR, Riley LE, Bateman BT, Henderson M. Implementation of a Quality Improvement Initiative to Decrease Opioid Prescribing After Cesarean Delivery. Obstetrics And Gynecology 2018, 132: 631-636. PMID: 30095765, PMCID: PMC6105442, DOI: 10.1097/aog.0000000000002789.Peer-Reviewed Original ResearchConceptsOpioid refill ratesOpioid tabletsCesarean deliveryOpioid prescribingRefill ratesAnalgesic useMean numberProspective quality improvement studyNonopioid analgesic useDays of dischargeNumber of opioidsPhase 2Quality improvement protocolPhase 1Quality improvement studyQuality improvement initiativesQuality improvement effortsDischarge providersAnalgesic prescriptionOpioid prescriptionsSecondary outcomesDischarge prescriptionsPrimary outcomeΧ analysisOpioids
2017
A Shared Decision-Making Intervention to Guide Opioid Prescribing After Cesarean Delivery
Prabhu M, McQuaid-Hanson E, Hopp S, Burns SM, Leffert LR, Landau R, Lauffenburger JC, Choudhry NK, Kaimal A, Bateman BT. A Shared Decision-Making Intervention to Guide Opioid Prescribing After Cesarean Delivery. Obstetrics And Gynecology 2017, 130: 42-46. PMID: 28594762, PMCID: PMC5482786, DOI: 10.1097/aog.0000000000002094.Peer-Reviewed Original ResearchConceptsCesarean deliveryDecision-making interventionLeftover opioid medicationsNumber of opioidsNumber of tabletsPain resolutionPostcesarean painOpioid medicationsOpioid prescribingOpioid useOxycodone tabletsMedian numberWomenPrescribingPrescriptionComputer-based decision aidDeliveryInterventionDecision aidStandard prescriptionPromising strategyHospitalizationMedicationsOpioidsPainPatterns of Opioid Prescription and Use After Cesarean Delivery
Bateman BT, Cole NM, Maeda A, Burns SM, Houle TT, Huybrechts KF, Clancy CR, Hopp SB, Ecker JL, Ende H, Grewe K, Corradini B, Schoenfeld RE, Sankar K, Day LJ, Harris L, Booth JL, Flood P, Bauer ME, Tsen LC, Landau R, Leffert LR. Patterns of Opioid Prescription and Use After Cesarean Delivery. Obstetrics And Gynecology 2017, 130: 29-35. PMID: 28594763, PMCID: PMC5600205, DOI: 10.1097/aog.0000000000002093.Peer-Reviewed Original ResearchConceptsAmount of opioidsOpioid prescriptionsCesarean deliveryMedian numberLeftover opioid medicationsPhone 2 weeksAcademic medical centerLeftover opioidsOpioid tabletsOpioid medicationsPain controlPain scoresPatient characteristicsOpioid analgesicsPatient satisfactionMedical CenterExcess medicationOpioidsMedicationsPrescriptionStructured interviewsConcomitant increaseWomenDeliveryAnalgesicsNeuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin
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. Anesthesia & Analgesia 2017, 125: 223-231. PMID: 28628578, DOI: 10.1213/ane.0000000000002173.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnesthesia, ConductionAnesthesia, ObstetricalAnesthesiologyAnestheticsAnticoagulantsCesarean SectionDelivery, ObstetricFemaleHematoma, Epidural, SpinalHeparinHeparin, Low-Molecular-WeightHumansMiddle AgedNerve BlockPregnancyPregnancy Complications, CardiovascularThrombosisYoung AdultConceptsSpinal epidural hematomaCases of SEHNeuraxial anesthesiaObstetric patientsVenous thromboembolismWeight heparinAnesthesia Closed Claims Project databaseSystematic reviewPractice changePostpartum venous thromboembolismVaginal delivery hospitalizationsWeight heparin doseRisk of thromboembolismLarge-scale registriesMajority of womenEnglish-language studiesAnticoagulated womenDelivery hospitalizationsPharmacological thromboprophylaxisAnticoagulant doseCesarean deliveryEpidural hematomaHeparin doseVaginal deliveryGeneral anesthesia
2015
Pregnancy complications in women with rare tumor suppressor syndromes affecting central and peripheral nervous system
Terry AR, Merker VL, Barker FG, Leffert L, Bateman BT, Souter I, Plotkin SR. Pregnancy complications in women with rare tumor suppressor syndromes affecting central and peripheral nervous system. American Journal Of Obstetrics And Gynecology 2015, 213: 108-109. PMID: 25687565, DOI: 10.1016/j.ajog.2015.02.013.Peer-Reviewed Original Research
2014
Continuous measurement of cardiac output with the electrical velocimetry method in patients under spinal anesthesia for cesarean delivery
Liu Y, Pian-Smith MC, Leffert LR, Minehart RD, Torri A, Coté C, Kacmarek RM, Jiang Y. Continuous measurement of cardiac output with the electrical velocimetry method in patients under spinal anesthesia for cesarean delivery. Journal Of Clinical Monitoring And Computing 2014, 29: 627-634. PMID: 25510959, DOI: 10.1007/s10877-014-9645-8.Peer-Reviewed Original ResearchConceptsPre-defined time pointsElective cesarean deliveryCardiac outputCesarean deliverySpinal anesthesiaStroke volumeNon-invasive CO monitorContinuous CO monitoringSystemic vascular resistanceTime pointsMajority of patientsPeripheral venous pressureTreatment of hypotensionOnset of hypotensionCO monitoringVascular resistanceHemodynamic profileVenous pressureHemodynamic changesPatient's hemodynamicsPhenylephrine bolusPhenylephrine administrationPatient outcomesObservational studyPatient management
2013
Spinal Anesthesia in Severe Preeclampsia
Henke VG, Bateman BT, Leffert LR. Spinal Anesthesia in Severe Preeclampsia. Anesthesia & Analgesia 2013, 117: 686-693. PMID: 23868886, DOI: 10.1213/ane.0b013e31829eeef5.Peer-Reviewed Original ResearchConceptsSevere preeclampsiaSpinal anesthesiaIntraoperative hemodynamic managementSpinal-induced hypotensionHealthy parturientsAnesthetic optionsCesarean deliveryEpidural catheterHemodynamic managementNeuraxial anesthesiaEpidural anesthesiaHigh incidencePreeclampsiaAnesthesiaHypotensionSignificant differencesParturientsContraindicationsCatheterIncidenceNeurofibromatosis type 1 and pregnancy complications: a population-based study
Terry AR, Barker FG, Leffert L, Bateman BT, Souter I, Plotkin SR. Neurofibromatosis type 1 and pregnancy complications: a population-based study. American Journal Of Obstetrics And Gynecology 2013, 209: 46.e1-46.e8. PMID: 23535241, DOI: 10.1016/j.ajog.2013.03.029.Peer-Reviewed Original ResearchMeSH KeywordsAdultCesarean SectionFemaleFetal Growth RetardationHumansHypertension, Pregnancy-InducedInfant, NewbornInternational Classification of DiseasesLogistic ModelsMaternal MortalityNeurofibromatosis 1Obstetric Labor, PrematurePre-EclampsiaPregnancyPregnancy ComplicationsRetrospective StudiesUnited StatesConceptsNeurofibromatosis type 1Diagnosis of NF1Deep venous thrombosis/pulmonary embolismPopulation-based retrospective cohort studyVenous thrombosis/pulmonary embolismType 1Pregnancy-related admissionsPregnancy-related hospitalizationsRetrospective cohort studyGeneral obstetric populationAcute cardiac eventsIntrauterine growth restrictionMultivariable logistic regressionPopulation-based studyGestational hypertensionMaternal morbidityObstetric populationPregnancy complicationsPreterm laborCardiac eventsCesarean deliveryCohort studyPeripartum complicationsPulmonary embolismCerebrovascular disease
2012
Outcomes of hospitalization in pregnant women with CNS neoplasms: a population-based study
Terry AR, Barker FG, Leffert L, Bateman BT, Souter I, Plotkin SR. Outcomes of hospitalization in pregnant women with CNS neoplasms: a population-based study. Neuro-Oncology 2012, 14: 768-776. PMID: 22513749, PMCID: PMC3367848, DOI: 10.1093/neuonc/nos078.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBostonBrain NeoplasmsCesarean SectionChildDelivery, ObstetricFemaleFetal Growth RetardationFollow-Up StudiesHospitalizationHumansMaternal MortalityObstetric Labor, PrematurePregnancyPregnancy Complications, NeoplasticPregnancy OutcomeRetrospective StudiesRisk FactorsSpinal NeoplasmsSurvival RateYoung AdultConceptsBenign brain tumorsIntrauterine growth restrictionMalignant brain tumorsNationwide Inpatient SamplePopulation-based studyCNS neoplasmsBrain tumorsCaesarean deliveryPreterm laborSpine tumorsPregnancy outcomesMaternal mortalityPregnancy-related admissionsAdverse pregnancy outcomesRetrospective cohort studyOutcomes of hospitalizationLogistic regression modelsPregnancy complicationsCohort studyHyperemesis gravidarumSurgical patientsObstetric riskPregnant womenInpatient SampleGrowth restriction
2010
The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries
Bateman BT, Berman MF, Riley LE, Leffert LR. The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries. Anesthesia & Analgesia 2010, 110: 1368-1373. PMID: 20237047, DOI: 10.1213/ane.0b013e3181d74898.Peer-Reviewed Original ResearchConceptsPostpartum hemorrhageUterine atonyRisk factorsCesarean deliveryRate of PPHCases of PPHIncidence of PPHSubstantial maternal morbidityIndependent risk factorClinical Modification codesNationwide Inpatient SampleLogistic regression modelingAntepartum haemorrhageDelivery complicationsHospital deathMaternal morbidityMaternal outcomesMultiple gestationsCommon complicationHospital admissionHypertensive diseaseCommon etiologyMaternal ageInpatient SampleContemporary epidemiology
2008
Acute Reversible Stress-Induced Cardiomyopathy Associated with Cesarean Delivery under Spinal Anesthesia
Crimi E, Baggish A, Leffert L, Pian-Smith MC, Januzzi JL, Jiang Y. Acute Reversible Stress-Induced Cardiomyopathy Associated with Cesarean Delivery under Spinal Anesthesia. Circulation 2008, 117: 3052-3053. PMID: 18541755, DOI: 10.1161/circulationaha.107.744102.Peer-Reviewed Original Research