At the water's edge: where obstetrics and anesthesia meet

Article Abstract:

In the past, fluid and food intake has been restricted for women in labor, a practice that is often stressful to the women but thought to be necessary for safety reasons if anesthesia is required. A critical evaluation of this policy and review of the medical literature relevant to it are presented. Although anesthesia is often cited as a major cause of maternal mortality (when stomach contents are vomited and then inhaled), very few anesthesia-linked deaths of obstetric patients have been reported in the medical literature. Yet many hospitals continue to totally forbid oral intake, while others allow only ice chips or limited amounts of liquids. These policies likely result from tradition rather than thoughtful decision-making. No reports have appeared that detail favorable effects on complication rates or mortality associated with these policies, nor have studies shown an increase in complications in birthing centers that allow eating and drinking during labor. In addition, the use of presurgical antacids, regional rather than general anesthesia, and appropriate obstetric and anesthesia practice and trained personnel further decrease the risk of aspiration. Prolonged fasting is detrimental to patients' health. After consideration of the facts, the following guidelines are offered: (1) Uncomplicated cases should be allowed a liquid diet as desired; (2) patients who will not be receiving regional anesthesia should be offered only enough intake for oral comfort; (3) regional anesthesia should be used when possible; (4) antacids should be given routinely before surgery; and (5) the standard lithotomy position (on the back, knees apart) and pressure on the abdomen should be avoided. Modern obstetrical practice no longer requires routine shaving, enemas, or 'nothing-by-mouth' policies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Anesthesia in obstetrics, Obstetrical anesthesia

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Law schools where women can excel

Article Abstract:

Duke has many women faculty members and ranks number one in Glamour's survey of law schools where women can succeed. Twenty universities are ranked and rated on women students and other factors. Rankings are compared with U.S. News & World Report ratings.

Education, Law schools, Women attorneys, Women lawyers

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Over the edge

Article Abstract:

The experiences of four people who have challenged their bodies to the limits by undertaking extreme sports are presented. Daryl Thompson had always enjoyed skateboarding, but the real thrill came from lying down and going as fast as he could.

Methods, Behavior, Athletes, Skateboarding

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