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December 2021 - Volume 41 - Issue 4

  • Patricia Dalby, MD
    Emily E. Sharpe, MD
    Rachel Kacmar, MD
  • 0275-665X
  • 1536-5395
  • 4 issues / year

In this issue of Obstetric Anesthesia Digest, we feature manuscripts about two topics that have been reviewed often in the obstetrical anesthesia literature. These manuscripts are unique in that they emphasize nuances that have not fully been discussed previously.

The first manuscript entitled, Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery by Loïc Sentilhes et al. in the N Engl J Med. 2021 Apr 29;384(17):1623-1634. This French Groupe de Recherche en Obstétrique et Gynécologie investigates the elective administration of tranexamic acid (TXA) in a controlled, randomized, multicenter, double blind very large group of women (n = 4153 evaluable) on blood loss after cesarean delivery. Although the therapeutic use of TXA has been extensively studied, the prophylactic use of TXA has not been studied in a large group of women. This manuscript has also generated several interesting commentaries in the literature Tranexamic acid and obstetric hemorrhage: give empirically or selectively? by A/ Shander et al. Also by the author of the featured article, Tranexamic acid for childbirth: why, when, and for whom.  By L. Sentilhes et al.

The second manuscript featured is found at which is Racial and Ethnic Disparities in Death Associated With Severe Maternal Morbidity in the United States: Failure to Rescue by Jean Guglielminotti et al. It was published in Obstet Gynecol . 2021 May 1;137(5):791-800. This was a retrospective cohort study using administrative data, that analyzed a national inpatient sample of 993,864 women that gave birth and had severe maternal morbidity during the years of 1999-2017. They broke down the population into racial and ethnic groups (non-Hispanic White (reference), non-Hispanic Black, Hispanic, other, and missing.) The investigation found an increase in morbidity in all groups initially then a decline starting in the early 2010’s. A conclusion of this study was that failure to rescue from severe maternal morbidity still contributes to disparate maternal mortality in racial and ethnic minority women.

OAD Editors,
Emily E. Sharpe, MD
Patricia L. Dalby, MD
Rachel Kacmar, MD 

Current Issue Highlights


Tranexamic Acid for the Prevention of Blood Loss After Cesarean Delivery

Sentilhes, L.; Sénat, M.V.; Le Lous, M.; More

Obstetric Anesthesia Digest. 41(4):159, December 2021.






Regional Analgesia


Regional Anesthesia


General Anesthesia


Postoperative Analgesia