Auditing the standard of anaesthesia care in obstetric units.

We undertook an audit of 15 obstetric units in the north of England over a 10-month period to ascertain to what extent they conformed to the Obstetric Anaesthetists' Association 'Recommended Minimum Standards for Obstetric Anaesthetic Services' using a quality assurance approach. We demonstrated that all units conformed to the majority of standards but did not conform in at least one major and minor area.

Caesarean section in patients with heart-lung transplants: a report of three cases and review.

There are increasing numbers of combined heart-lung transplants being carried out in young people for end-stage pulmonary disease. There have-to-date been few reports of pregnancy in heart-lung transplant recipients. We report on the successful outcome of three pregnancies involving two patients following heart-lung transplantation. The importance of an interdisciplinary approach to the care of such patients throughout pregnancy is clear. The deliveries were carried out by caesarean section under regional anaesthesia and the discussion focuses on the choice of anaesthesia along with the problems these patients present to the anaesthetist. Regional anaesthesia appears to be a safe technique in these patients. However, it is important to appreciate that the response to vasoactive drugs may be unpredictable and that intravenous fluid should be administered carefully as they are at risk of fluid overload and pulmonary oedema.

A model of women's health nursing.

A holistic model of women's health nursing is developed, using Lancaster and Lancaster's (1981) steps in model building. The model is based on women's conscious awareness of problems existing in eight identified categories. Depression and problems with sexuality are permeating concepts within the model, because women's problems influence and are influenced by these concepts. Integration of the body, mind, and spirit is the overarching concept in the model, because integration may be altered when problems exist within the eight categories. Interrelationships among the categories of the model and the goals of the model are presented. The model provides the practitioner with a systematic way of organizing collected data.

Recurrent anaphylactoid reaction during caesarean section.

A 28-year-old woman presented for emergency Caesarean section at 31 weeks' gestation with deranged liver function and a history of recurrent anaphylactoid reactions during previous pregnancy-related anaesthetics. The anaesthetic management and outcome of this case is presented.