2022
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
Katz D, Bateman B, Kjaer K, Turner D, Spence N, Habib A, George R, Toledano R, Grant G, Madden H, Butwick A, Lynde G, Minehart R, Beilin Y, Houle T, Sharpe E, Kodali B, Bharadwaj S, Farber M, Palanisamy A, Prabhu M, Gonzales N, 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. Obstetric Anesthesia Digest 2022, 42: 27-28. DOI: 10.1097/01.aoa.0000816828.87126.61.Peer-Reviewed Original ResearchThe relationship between INTEM/HEPTEM coagulation time ratio and heparin plasma concentration in obstetric patients: an exploratory in vitro investigation
Katz D, Leffert L, Getrajdman C, Sison M, Shin DW, Lin HM, Butwick A. The relationship between INTEM/HEPTEM coagulation time ratio and heparin plasma concentration in obstetric patients: an exploratory in vitro investigation. Journal Canadien D'anesthésie 2022, 69: 597-604. PMID: 35102496, DOI: 10.1007/s12630-022-02193-5.Peer-Reviewed Original ResearchConceptsObstetric patientsUnfractionated heparinConcentration of heparinHeparin activityHeparin concentrationPartial thromboplastin time (aPTT) testingCT ratioCare coagulation testsHeparin plasma concentrationsResultsSeventy-seven patientsPartial thromboplastin timeUncomplicated pregnanciesThird trimesterNeuraxial anestheticPlasma concentrationsCoagulation testsThromboplastin timeBlood samplesPatientsHeparinAPTTHematocrit rangeVitro investigationBloodTime ratio
2021
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. Obstetric Anesthesia Digest 2021, 41: 164-165. DOI: 10.1097/01.aoa.0000796068.53863.3d.Peer-Reviewed Original ResearchWhat’s New in Neuraxial Labor Analgesia
Toledano RD, Leffert L. What’s New in Neuraxial Labor Analgesia. Current Anesthesiology Reports 2021, 11: 340-347. PMID: 34466127, PMCID: PMC8390543, DOI: 10.1007/s40140-021-00453-6.Peer-Reviewed Original ResearchNeuraxial labor analgesiaEpidural drug deliveryLabor analgesiaObstetric patientsCesarean delivery anesthesiaNeuraxial analgesiaGeneral anesthesiaDelivery anesthesiaObstetric anesthesiaNeuraxial proceduresCOVID-19Spinal epidural hematoma formationSARS-CoV-2 infectionSerious adverse eventsEmergency cesarean deliveryCommon serious complicationEpidural labor analgesiaEpidural hematoma formationPain of childbirthAnalgesia techniquesEpidural blockadeAdverse eventsCesarean deliveryRisk/benefit decisionsAnesthetic managementThe Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia
Bauer ME, Arendt K, Beilin Y, Gernsheimer T, Perez Botero J, James AH, Yaghmour E, Toledano RD, Turrentine M, Houle T, MacEachern M, Madden H, Rajasekhar A, Segal S, Wu C, Cooper JP, Landau R, Leffert L. The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia. Anesthesia & Analgesia 2021, 132: 1531-1544. PMID: 33861047, DOI: 10.1213/ane.0000000000005355.Peer-Reviewed Original ResearchConceptsSpinal epidural hematomaObstetric patientsNeuraxial proceduresImmune thrombocytopeniaEpidural hematomaGeneral anesthesiaRisk factorsObstetric risk factorsRisk-benefit discussionsDiagnosis of thrombocytopeniaRelevant professional societiesInterdisciplinary consensus statementGestational thrombocytopeniaThrombocytopenia etiologyHypertensive disordersPatient comorbiditiesCesarean deliveryProfessional societiesAirway examinationPotential morbidityPlatelet countPatient preferencesObstetric anesthesiaAirway equipmentAffected 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
Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low–Molecular-Weight Heparin
Leffert L, Dubois H, Butwick A, Carvalho B, Houle T, Landau R. Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low–Molecular-Weight Heparin. Obstetric Anesthesia Digest 2018, 38: 3-4. DOI: 10.1097/01.aoa.0000529964.63597.d5.Peer-Reviewed Original ResearchSpinal epidural hematomaObstetric patientsNeuraxial anesthesiaWeight heparinVenous thromboembolismCesarean deliveryEpidural hematomaPregnant womenNeuraxial blockadeNational guidelinesPatientsThromboprophylaxisHeparinAnesthesiaSafe useWomenLow-MolecularThromboembolismHematomaBlockadeReview reportsPresent review reportsThe Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants
Leffert L, Butwick A, Carvalho B, Arendt K, Bates SM, Friedman A, Horlocker T, Houle T, Landau R, Dubois H, Fernando R, Houle T, Kopp S, Montgomery D, Pellegrini J, Smiley R, Toledo P. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesthesia & Analgesia 2018, 126: 928-944. PMID: 29099429, DOI: 10.1213/ane.0000000000002530.Peer-Reviewed Original ResearchConceptsHigh-dose anticoagulantsConsensus statementMaternal deathsObstetric anesthesiaNeuraxial proceduresPerinatology Consensus StatementPharmacodynamics of anticoagulantsUse of thromboprophylaxisRisk-benefit discussionsKey preventive measuresObstetric populationObstetric surgeryCesarean deliveryNeuraxial analgesiaVenous thromboembolismAnesthetic managementObstetric patientsDifficult airwayNeuraxial anesthesiaGeneral anesthesiaPostpartum womenPregnant womenFetal harmPostpartum periodLeading cause
2017
Neuraxial 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 anesthesiaIntegrating the New Thromboprophylaxis Guidelines Into Obstetric Anesthesia Practice
Leffert L, Landau R. Integrating the New Thromboprophylaxis Guidelines Into Obstetric Anesthesia Practice. Survey Of Anesthesiology 2017, 61: 14. DOI: 10.1097/01.sa.0000513496.39516.43.Peer-Reviewed Original ResearchVenous thromboembolismPatient care recommendationsObstetric anesthesia practiceConsensus BundleThromboprophylaxis guidelinesVTE ratesMaternal deathsNeuraxial anesthesiaObstetric patientsObstetric anesthesiaCare recommendationsAnesthesia practiceAnesthesiaNational PartnershipRiskThromboembolismPatients
2011
Regulatory and electronic alphabet soup: practice improvements and implications for providers.
Tracy EE, Leffert LR, Clark VL, Ecker J. Regulatory and electronic alphabet soup: practice improvements and implications for providers. Technology And Health Care 2011, 19: 341-7. PMID: 22027153, DOI: 10.3233/thc-2011-0640.Peer-Reviewed Original Research