Cardiac arrest: an unexpected complication during laparoscopic bilateral tubal ligation - a rare case report

Data consistently show that in experienced trained hands, laparoscopic tubal sterilization is safe and highly effective regardless of the approach or occlusive method. The known mortality rate is between four and eight deaths per 100,000 cases and the rate of intraoperative and postoperative major complications is less than 1%. The anesthetic complication rate for laparoscopy is between 0.016% and 0.75%. Carbon dioxide (CO2) pneumoperitoneum effects are still controversial. Here the authors present a case report of patient who suffered from intraoperative cardiac arrest during laparoscopic tubal ligation under general anesthesia. No definite cause has been identified. The authors outline several possible mechanisms that could have been involved and attempt to discuss these events in the face of published reports describing similar complications

Maternal inflammation during late pregnancy is lower in physically active compared with inactive obese women

PURPOSE: The primary purpose of this study was to compare maternal plasma inflammation between physically active and inactive obese women during late pregnancy. The secondary purpose was to examine the relationships between maternal plasma inflammation and lipid metabolism and maternal and neonatal metabolic health in these women. METHODS: A cross-sectional, observational study design was performed in 16 obese-inactive ((OBI) age: 25.0 ± 4.8 years, pre-pregnancy BMI: 36.3 ± 4.3kg/m(2), body fat percentage in late gestation: 37.7 ± 3.5%) and 16 obese-active ((OBA) age: 28.9 ± 4.8 years, pre-pregnancy BMI: 34.0±3.7kg/m(2), body fat in late gestation: 36.6 ± 3.8%) women during the third trimester of pregnancy. Maternal plasma inflammation (C -reactive protein (CRP)) and insulin resistance (Homeostatic Model Assessment-Insulin Resistance (HOMA-IR)) were measured at rest. Plasma lipid concentration and metabolism (lipid oxidation and lipolysis) were measured at rest, during a 30-minute bout of low-intensity (40% VO(2peak)) exercise, and during a resting recovery period using indirect calorimetry. Umbilical cord blood was collected for measurement of neonatal plasma insulin resistance, inflammation, and lipid concentration. Neonatal body composition was measured via air displacement plethysmography. RESULTS: Maternal plasma CRP concentration was significantly higher in OBI compared to OBA women (9.1 ± 4.0 mg/L versus 6.3 ±2.5mg/L, p=0.02). Maternal plasma CRP concentration was significantly associated with maternal lipolysis (r=0.43, p=0.02), baseline lipid oxidation rate (r=0.39, p=0.03), and baseline plasma free fatty acid concentration (r=0.36, p=0.04). CONCLUSIONS: Maternal physical activity may reduce inflammation during pregnancy in obese women. Maternal lipid metabolism is related to systemic inflammation