International journal of obstetric anesthesia

Publisher: Elsevier

Journal description

Current impact factor: 1.83

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.832
2012 Impact Factor 1.799
2011 Impact Factor 1.395
2010 Impact Factor 1.793
2009 Impact Factor 1.847
2008 Impact Factor 1.757
2007 Impact Factor 1.465
2006 Impact Factor 1.621
2005 Impact Factor 1.11
2004 Impact Factor 0.894
2003 Impact Factor 0.927
2002 Impact Factor 0.963
2001 Impact Factor 1.187
2000 Impact Factor 1.274
1999 Impact Factor 0.516

Impact factor over time

Impact factor

Additional details

5-year impact 1.68
Cited half-life 5.10
Immediacy index 0.34
Eigenfactor 0.00
Article influence 0.36
Other titles International journal of obstetric anesthesia (Online), International journal of obstetric anesthesia
ISSN 1532-3374
OCLC 45287992
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • International journal of obstetric anesthesia 06/2015; DOI:10.1016/j.ijoa.2015.06.006
  • International journal of obstetric anesthesia 06/2015; DOI:10.1016/j.ijoa.2015.06.004
  • [Show abstract] [Hide abstract]
    ABSTRACT: Drugs used in obstetric patients must accomplish two goals: efficacy and safety for both mother and fetus. Neostigmine has been co-administered epidurally and intrathecally with local anesthetics and other adjuncts in the obstetric setting. The aim of this meta-analysis was to assess the efficacy and incidence of adverse events related to the use of neostigmine in obstetric anesthesia. A meta-analysis of randomized-controlled human trials was conducted using the data sources Google Scholar and PubMed (updated 1 November 2014). Inclusion criteria were: random allocation to treatment; comparison of neostigmine or neostigmine with local anesthetics and/or other adjuvants versus placebo or placebo with local anesthetics and/or other adjuvants; and approval by an ethics committee. The use of neostigmine as an adjuvant in neuraxial anesthesia is associated with a reduction in the dose of local anesthetic during labor analgesia and postoperative analgesia following cesarean section: mean reduction of local anesthetic (ropivacaine or bupivacaine) vs. control -4.08 (95% CI -6.7 to -1.5) mg/h (P=0.002). The risk of nausea was increased vs. control with intrathecal neostigmine (OR 8.99 [95% CI 4.74 to 17.05], P <0.001) but not with epidural neostigmine (OR 0.97 [95% CI 0.46 to 2.05], P=0.94). Use of neuraxial neostigmine was associated with a decrease in the risk of pruritus but there was no increase in the incidence of hypotension, dizziness or sedation and no effect on the incidence of abnormal fetal heart rate patterns or Apgar scores. Neuraxial administration of neostigmine significantly reduces local anesthetic consumption without serious adverse side effects to the mother or fetus. However, neostigmine is only recommended for epidural administration as intrathecal use significantly increases the incidence of maternal nausea and vomiting. Copyright © 2015 Elsevier Ltd. All rights reserved.
    International journal of obstetric anesthesia 05/2015; DOI:10.1016/j.ijoa.2015.05.002
  • International journal of obstetric anesthesia 05/2015; DOI:10.1016/j.ijoa.2015.04.006
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    ABSTRACT: Parturients with super-morbid obesity, defined as body mass index greater than 50kg/m(2), represent a growing segment of patients who require anesthetic care for labor and delivery. Severe obesity and its comorbid conditions place the parturient and fetus at greater risk for pregnancy complications and cesarean delivery, as well as surgical and anesthetic complications. The surgical approach for cesarean delivery in these patients may require a supra-umbilical vertical midline incision due to a large pannus. The dense T4-level of spinal anesthesia can cause difficulties with ventilation for the obese patient during the procedure, which can be prolonged. Patients also may have respiratory complications in the postoperative period due to pain from the incision. We describe the anesthetic management of three parturients with body mass index ranging from 73 to 95kg/m(2) who had a cesarean delivery via a supra-umbilical vertical midline incision. Continuous lumbar spinal and low thoracic epidural catheters were placed in each patient for intraoperative anesthesia and postoperative analgesia, respectively. Continuous spinal catheters were dosed with incremental bupivacaine boluses to achieve surgical anesthesia. In one case, the patient required respiratory support with non-invasive positive pressure ventilation. Two cases were complicated by intraoperative hemorrhage. All patients had satisfactory postoperative analgesia with a thoracic epidural infusion. None suffered postoperative respiratory complications or postdural puncture headache. The use of a continuous lumbar spinal catheter and a low thoracic epidural provides several advantages in the anesthetic management of super-morbidly obese parturients for cesarean delivery. Copyright © 2015 Elsevier Ltd. All rights reserved.
    International journal of obstetric anesthesia 04/2015; DOI:10.1016/j.ijoa.2015.04.001
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    ABSTRACT: Recent advances in the diagnosis, pathogenesis, and understanding of preeclampsia-related morbidity provide opportunities to optimize clinical management of the mother and fetus. These discoveries are timely, as contemporary data suggest that the prevalence of preeclampsia, affecting 7.5% of pregnancies globally and 2-5% in the USA, has increased by up to 30% over the last decade. Managing pregnant patients with preeclampsia can be challenging for all members of the obstetric care team due to the disease's multi-organ system maternal and fetal effects. This review presents recent updates in the definition of preeclampsia, etiology, comorbidities and therapeutic interventions and discusses how they impact the care of these high-risk patients. Copyright © 2015 Elsevier Ltd. All rights reserved.
    International journal of obstetric anesthesia 03/2015; DOI:10.1016/j.ijoa.2015.03.008
  • International journal of obstetric anesthesia 03/2015; DOI:10.1016/j.ijoa.2015.03.009
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    ABSTRACT: Oxytocin administration to prevent uterine atony following cesarean delivery is associated with adverse effects including hypotension, tachycardia, and nausea. Calcium chloride increases mean arterial pressure, systemic vascular resistance, and uterine smooth muscle contractility. This study evaluated whether the co-administration of calcium chloride with oxytocin following cesarean delivery could alter maternal hemodynamics. Secondary outcomes included uterine tone and blood loss. Sixty healthy parturients with singleton, term, vertex pregnancies undergoing elective cesarean delivery under spinal anesthesia were randomized to one of three study solutions given intravenously immediately after umbilical cord clamping: (1) placebo, oxytocin 5U alone; (2) CA-200, oxytocin 5U+calcium chloride 200mg; or (3) CA-400, oxytocin 5U+calcium chloride 400mg. Blood pressure, heart rate, uterine tone, vasopressor or alternate uterotonic use and the incidence of nausea or vomiting were recorded. Baseline and intraoperative plasma concentration of ionized calcium and hematocrit were measured. Plasma concentration of ionized calcium was elevated in both study groups compared with placebo (P=0.001). Blood pressure decreased and heart rate increased in all groups (P <0.0001), with no differences between groups. No differences were observed between groups in uterine tone, vasopressor use, hematocrit change, estimated blood loss, incision-to-delivery interval, delivery-to-skin closure interval, total intravenous fluid administered or incidence of nausea. The decrease in blood pressure associated with oxytocin administration following cesarean delivery was not attenuated with co-administration of calcium chloride at the doses evaluated. Vasopressor use, uterine tone, and blood loss were also unaffected. Copyright © 2015 Elsevier Ltd. All rights reserved.
    International journal of obstetric anesthesia 03/2015; DOI:10.1016/j.ijoa.2015.03.007
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    ABSTRACT: There is little evidence on the influence of bevel direction of a pencil-point needle on the median effective dose (ED50) of isobaric ropivacaine and fentanyl in spinal anesthesia for cesarean delivery. In this prospective, double-blind, sequential allocation study, 82 parturients scheduled for elective cesarean delivery under combined spinal-epidural anesthesia were included. We sought to determine the median effective dose of intrathecal 0.75% isobaric ropivacaine plus fentanyl 15μg with two different bevel directions of a 26-gauge Whitacre needle using up-down sequential allocation. Parturients were randomly allocated to either Group Ce (needle aperture oriented in a cephalad direction) or Group Ca (aperture directed caudally). The initial dose was 0.75% ropivacaine 11.25mg plus fentanyl 15μg in both groups. Each dose was classified as effective if, after 15min and during the next 60min, there was inability to appreciate pin-prick as sharp at T4, a visual analogue pain score <2 and no requirement for an epidural rescue bolus. Eighty patients were included in the analysis. The ED50 in group Ca was significantly higher (13.09mg, 95% CI 12.19-14.00) than in group Ce (10.10mg, 95% CI 9.54-10.65, P <0.001). The orientation of the distal aperture of a 26-gauge Whitacre needle during induction of spinal anesthesia for cesarean delivery influences the ED50 of 0.75% ropivacaine. Copyright © 2015 Elsevier Ltd. All rights reserved.
    International journal of obstetric anesthesia 03/2015; DOI:10.1016/j.ijoa.2015.03.005
  • International journal of obstetric anesthesia 03/2015; 24. DOI:10.1016/j.ijoa.2015.02.007
  • International journal of obstetric anesthesia 03/2015; 24(2). DOI:10.1016/j.ijoa.2015.03.001
  • International journal of obstetric anesthesia 02/2015; DOI:10.1016/j.ijoa.2015.02.009
  • International journal of obstetric anesthesia 02/2015; 24(2). DOI:10.1016/j.ijoa.2015.02.002
  • International journal of obstetric anesthesia 02/2015; 24(2). DOI:10.1016/j.ijoa.2015.02.005
  • International journal of obstetric anesthesia 02/2015; 24(2). DOI:10.1016/j.ijoa.2015.02.004
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    ABSTRACT: Introduction Recovery of balance after neuraxial anaesthesia can remain delayed after simple clinical tests have demonstrated motor recovery. Dynamic posturography tracks the small movements or sway of a person standing as still as possible on a force platform and has been investigated as an objective measure of the ability to walk following anaesthesia. These are expensive laboratory devices, limiting their clinical utility. One measured variable is path length, the cumulative distance travelled in the horizontal plane by the centre of pressure of a person standing on the platform over one minute. Path length can be measured using the Nintendo Wii-Fit Balance Board™. Methods The feasibility of intercepting raw wireless data from a Nintendo® Wii-Fit Balance Board™ using custom software to calculate path length was explored. Subsequently, path lengths were measured using both this and a laboratory platform simultaneously. In a random order 20 volunteers(a) stood for 1 min, feet together, eyes open (conventional baseline test); and (b) stood for 1 min, feet together, eyes closed (simulating residual anaesthesia with increased sway). For each device, the ratio b:a was calculated as an index of performance reduction when eyes were closed. Results Path lengths ranged from 58.50 to 242.99 cm, mean bias 9cm (Wii-Fit < laboratory platform) and 95% confidence limits of 2.5 to 15.4 cm. Ratios ranged from 1.09 to 2.68, mean bias -0.04 (Wii-Fit > laboratory platform) and 95% confidence limits of 0.04 to -0.13. Conclusions The path lengths were in close agreement and the Wii-Fit Balance Board™ may be worthy of further investigation as a tool to objectively assess readiness to ambulate following neuraxial anaesthesia.
    International journal of obstetric anesthesia 08/2014; 23(3). DOI:10.1016/j.ijoa.2014.02.001
  • International journal of obstetric anesthesia 08/2014; 23(3). DOI:10.1016/j.ijoa.2014.04.010
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    ABSTRACT: Background In obstetrics, post-dural puncture headache is a well-recognised complication. Typical symptoms include fronto-temporal or occipital headache, worsening with ambulation and improving in the decubitus position. Occasionally, patients present with non-postural headache, although relatively little is known about this atypical presentation. The purpose of this study was to determine the incidence, associated signs and risk factors for this atypical manifestation of post-dural puncture headache. Methods We analysed a series of 27 064 parturients having a neuraxial procedure between January 2001 and December 2010. Using data from electronic anaesthesia patient records, medical charts and a postpartum quality audit, we identified all parturients with atypical post-dural puncture headache. We assessed the incidence and used uni- and multivariate analysis to identify associated risk factors. Results Amongst 142 parturients with post-dural puncture headache, eight [5.6% (95% CI 1.7–9.4%)] had atypical non-postural headache. Associated symptoms were stiffness and pain in the cervical, thoracic or lumbar vertebral area, visual disturbances and vertigo. Significant risk factors for developing atypical signs were previous migraine, odds ratio 6.1 (95% CI 1.2–28.7), a more cephalad level of needle insertion, odds ratio 17.2 (95% CI 1.4–210.1) and identification of dural puncture by aspiration of cerebrospinal fluid from the epidural catheter, odds ratio 5.5 (95%CI 1.2–24.4). Following multivariate analysis, recognition of dural puncture by aspiration of cerebrospinal fluid from the epidural catheter was the most significant predictor of non-orthostatic postdural puncture headache. Conclusion Anaesthetists should be aware of this atypical clinical presentation, particularly if there is a past history of migraine, a more cephalad level of needle insertion or identification of dural puncture by aspiration of cerebrospinal fluid from the epidural catheter.
    International journal of obstetric anesthesia 08/2014; 23(3). DOI:10.1016/j.ijoa.2014.04.005
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    ABSTRACT: Posterior reversible encephalopathy syndrome (PRES) is a rare neurological condition associated with a variety of underlying conditions, including preeclampsia. The headache associated with PRES may be indistinguishable from post-dural puncture headache, which may result in diagnostic delay. We report a case of PRES that was initially diagnosed as post-dural puncture headache. The case was unique because there were no features of preeclampsia, initial presentation was typical of post-dural puncture headache, and there was a five-day interval between the onset of headache and the development of seizures and cortical blindness, pathognomonic of PRES. It remains unclear whether this was an atypical presentation of PRES, initially misdiagnosed as post-dural puncture headache, or whether delayed treatment of headache triggered PRES.
    International journal of obstetric anesthesia 08/2014; 23(3). DOI:10.1016/j.ijoa.2014.02.003
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    ABSTRACT: Background Spinal anaesthesia performed at levels higher than the L3-4 intervertebral space may result in spinal cord injury. Our aim was to establish a protocol to reduce the chance of spinal anaesthesia performed at or above L2-3. Methods One hundred and ten consenting patients at 32 weeks of gestation or greater scheduled for non-emergency caesarean section under spinal anaesthesia were randomly allocated to have needle insertion performed at an intervertebral space determined by one of two landmark techniques. In Group A, if the intercristal line intersected an intervertebral space, this space was selected or if the intercristal line intersected a spinous process the space immediately above was selected. In Group B, if the intercristal line intersected an intervertebral space or a spinous process, the intervertebral space immediately below was chosen. The actual intervertebral space chosen was identified using ultrasound by a blinded investigator. Results In Group A, an intervertebral space at or above L2-3 was marked in 25 (45.5%) patients compared with 4 (7.3%) in Group B (P <0.001). In 5/55 (9.1%) patients in Group A, the intervertebral space initially chosen was L1-2 whereas this occurred in no patient in Group B. There was no difference between groups in number of needle passes or attempts, onset of block at 5, 10 and 15 min or need for rescue analgesia. Conclusion Our data suggest that when performing spinal anaesthesia in pregnant patients, if the intercristal line intersects an intervertebral space then the space below should be chosen and if the intercristal line intersects a spinous process then the interspace below should be chosen. This will reduce the incidence of spinal anaesthesia performed at or above L2-3.
    International journal of obstetric anesthesia 08/2014; 23(3). DOI:10.1016/j.ijoa.2014.02.004