ABSTRACT
Epidural and spinal anesthesia is a routine anesthetic procedure and considered the standard of care for intrapartum analgesia. Complications of epidurals vary greatly from temporary hypotension to meningitis and intracranial bleeds. Intracranial subdural hemorrhages are considered a rare but serious complication that may have significant long-term morbidity, particularly for postpartum women. The most common complication is a postdural puncture headache and patients with intracranial subdural hemorrhage present with similar symptoms.1 Imaging may be necessary to differentiate the 2 conditions and ensure patients are treated correctly.
ABSTRACT
BACKGROUND: Preterm birth (PTB), defined as delivery before 37 weeks' gestation, is a multifactorial condition that can lead to neonatal mortality and morbidity. Short cervical length (CL) found on morphological scan is associated with an elevated risk of spontaneous PTB. Identifying these women at risk allows clinicians the opportunity to treat and prevent PTB. OBJECTIVE: This article reviews current approaches to the evaluation and management of a shortened CL at morphology scan and highlights important patient counselling points. DISCUSSION: Current Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines provide consensus-based recommendations; a shortened cervix measuring less than 25 mm on a transvaginal ultrasound scan at 18-24 weeks' gestation requires management. There are three management pathways when a short cervix is identified on morphology scan: conservative, medical and surgical. General practitioners involved in the antenatal care of pregnant women may assist in counselling these women about their options.
