Scholars@Duke
Jennifer Estrella Dominguez

Jennifer Estrella Dominguez

Associate Professor of Anesthesiology
Anesthesiology, Women's

Selected Publications

The Role of Sleep Apnea in Postoperative Neurocognitive Disorders Among Older Noncardiac Surgery Patients: A Prospective Cohort Study.

Journal Article Anesth Analg · January 1, 2025 BACKGROUND: Obstructive sleep apnea is associated with increased dementia risk, yet its role in postoperative neurocognitive disorders is unclear. Here, we studied whether the severity of untreated obstructive sleep apnea is associated with the severity of ... Full text Link to item Cite

Morbid obesity: Optimizing neuraxial analgesia and cesarean delivery outcomes.

Journal Article Best Pract Res Clin Anaesthesiol · September 2024 The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to ... Full text Link to item Cite

A survey of United States obstetric anesthesiologists' perceived value of obstetric anesthesiology fellowship.

Journal Article Int J Obstet Anesth · November 2023 INTRODUCTION: Subspecialty training in obstetric anesthesiology is associated with improved patient outcomes and reduced anesthesia-related morbidity and mortality. Despite this, the demand for fellowship-trained obstetric anesthesiologists far exceeds the ... Full text Link to item Cite

Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation.

Journal Article J Vis Exp · September 22, 2023 Over the past two decades, diagnostic point-of-care ultrasound (POCUS) has emerged as a rapid and non-invasive bedside tool for addressing clinical inquiries related to gastric content. One emerging concern pertains to patients about to undergo sedation an ... Full text Link to item Cite

Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology Consensus Guideline on the Screening, Diagnosis, and Treatment of Obstructive Sleep Apnea in Pregnancy.

Journal Article Obstet Gynecol · August 1, 2023 The Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology tasked an expert group to review existing evidence and to generate recommendations on the screening, diagnosis, and treatment of patients with obstructiv ... Full text Link to item Cite

Obstructive Sleep Apnea Among Gravidas With Chronic Hypertension Compared to Matched Controls: A Prospective Cohort Study.

Journal Article Anesth Analg · February 1, 2023 BACKGROUND: Previous studies of obstructive sleep apnea (OSA) risk in gravidas with chronic hypertension (cHTN) did not control for obesity as a risk factor for OSA. We therefore performed this study to evaluate whether OSA is more prevalent among gravidas ... Full text Link to item Cite

Anesthesia and Analgesia for the Obese Parturient.

Journal Article Adv Anesth · December 2022 Obesity is a worldwide epidemic and is associated with an increased risk of hypertension, diabetes, and obstructive sleep apnea. Pregnant patients with obesity experience a higher risk of maternal and fetal complications. Anesthesia also poses higher risks ... Full text Link to item Cite

Obstructive sleep apnea in pregnant women.

Journal Article Int Anesthesiol Clin · April 1, 2022 The prevalence of OSA in the low-risk obstetric population is thought to be low; best estimates have been extrapolated from the one available large prospective study and likely range between 3–8%. OSA prevalence in high-risk pregnant women such as those wi ... Full text Link to item Cite

Postpartum Respiratory Depression.

Journal Article Anesthesiol Clin · December 2021 Postpartum respiratory depression is a complex, multifactorial issue that encompasses a patient's baseline preexisting conditions, certain pregnancy-specific conditions or complications, as well as the iatrogenic element of various medications given in the ... Full text Link to item Cite

Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial.

Journal Article Anesthesiol Res Pract · 2021 OBJECTIVES: Dexamethasone has been shown to have analgesic properties in the general surgical population. However, the analgesic effects for women that undergo cesarean deliveries under spinal anesthesia remain unclear and may be related to the timing of d ... Full text Link to item Cite

Tonic-clonic seizure after unrecognized unintentional dural puncture.

Journal Article Int J Obstet Anesth · November 2020 Patients who suffer an unintentional dural puncture have a high risk of developing a post-dural puncture headache. Other neurologic complications have been reported, but seizure is rarely seen. We present a case of a 21-year-old primigravida who experience ... Full text Link to item Cite

Ropivacaine and Ketorolac Wound Infusion for Post-Cesarean Delivery Analgesia: A Randomized Controlled Trial.

Journal Article Obstet Gynecol · February 2020 OBJECTIVE: To evaluate the efficacy of wound infusion with ropivacaine plus ketorolac compared with placebo for post-cesarean delivery analgesia in women who received a multimodal analgesic regimen including intrathecal morphine. METHODS: In a randomized d ... Full text Link to item Cite

Sleep-disordered Breathing in Pregnancy

Chapter · January 1, 2020 The proportion of the world’s population that is obese has tripled over the last 40 years, according to data from the World Health Organization. Women are more likely to be obese than their age- and country-matched male counterparts; women of reproductive ... Full text Cite

Reply.

Journal Article Am J Obstet Gynecol · April 2019 Full text Link to item Cite

Obesity And Obstetric Anesthesia: Current Insights.

Journal Article Local Reg Anesth · 2019 Obesity is a significant global health problem. It results in a higher incidence of complications for pregnant women and their neonates. Cesarean deliveries are more common in obese parturients as well. The increased burden of comorbidities seen in this po ... Full text Link to item Cite

A review of the associations between obstructive sleep apnea and hypertensive disorders of pregnancy and possible mechanisms of disease.

Journal Article Sleep Med Rev · December 2018 Obesity is prevalent among pregnant women in the United States; 15-20% of obese pregnant women have obstructive sleep apnea. The prevalence of obstructive sleep apnea increases along with body mass index, age and in the presence of other co-morbidities. Un ... Full text Link to item Cite

Screening extremely obese pregnant women for obstructive sleep apnea.

Journal Article Am J Obstet Gynecol · December 2018 BACKGROUND: Obesity is prevalent among pregnant women in the United States; obstructive sleep apnea is highly comorbid with obesity and is associated with adverse pregnancy outcomes. Screening for obstructive sleep apnea in pregnant women has remained a ch ... Full text Link to item Cite

Obstructive Sleep Apnea in Pregnant Women: A Review of Pregnancy Outcomes and an Approach to Management.

Journal Article Anesth Analg · November 2018 Among obese pregnant women, 15%-20% have obstructive sleep apnea (OSA) and this prevalence increases along with body mass index and in the presence of other comorbidities. Prepregnancy obesity and pregnancy-related weight gain are certainly risk factors fo ... Full text Link to item Cite

Management of Obstructive Sleep Apnea in Pregnancy.

Journal Article Obstet Gynecol Clin North Am · June 2018 The spectrum of sleep-disordered breathing (SDB) ranges from mild snoring to obstructive sleep apnea, the most severe form of SDB. Current recommendations are to treat these women with continuous positive airway pressure despite limited data. SDB in early ... Full text Link to item Cite

A randomized trial of phenylephrine infusion versus bolus dosing for nausea and vomiting during Cesarean delivery in obese women.

Journal Article Can J Anaesth · March 2018 PURPOSE: Hypotension is common after spinal anesthesia for Cesarean delivery. It is associated with nausea, vomiting, and fetal acidosis. Previous research on phenylephrine excluded obese subjects. We compared the incidence of intraoperative nausea and vom ... Full text Link to item Cite

Multidisciplinary approach to manage antenatally suspected placenta percreta: updated algorithm and patient outcomes.

Journal Article Gynecol Oncol Res Pract · 2017 BACKGROUND: Due to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percret ... Full text Open Access Link to item Cite

Blood-Conservation Strategies in a Blood-Refusal Parturient with Placenta Previa and Placenta Percreta.

Journal Article A A Case Rep · March 1, 2016 Abnormal placentation can be associated with significant blood loss and massive blood transfusions. Caring for parturients with abnormal placentation who refuse blood transfusion is very challenging. We present a 35-year-old, gravida 3, para 1, Jehovah's W ... Full text Link to item Cite

Anesthetic management of super-morbidly obese parturients for cesarean delivery with a double neuraxial catheter technique: a case series.

Journal Article Int J Obstet Anesth · August 2015 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 ... Full text Link to item Cite

A retrospective assessment of the incidence of respiratory depression after neuraxial morphine administration for postcesarean delivery analgesia.

Journal Article Anesth Analg · December 2013 Respiratory depression can occur after neuraxial morphine administration. In the obstetric population, there are little data on respiratory depression after neuraxial morphine administration in women undergoing cesarean delivery. In this single-center, ret ... Full text Link to item Cite

Prophylaxis and treatment of the side-effects of neuraxial morphine analgesia following cesarean delivery.

Journal Article Curr Opin Anaesthesiol · June 2013 PURPOSE OF REVIEW: Neuraxial morphine is commonly used for analgesia after cesarean delivery, but is frequently associated with postoperative nausea and vomiting (PONV) and pruritus. This review describes the recent advances in the management of those side ... Full text Link to item Cite

Leptin levels and luteinizing hormone pulsatility in normal cycling women and their relationship to daily changes in metabolic rate.

Journal Article Fertil Steril · October 2008 OBJECTIVE: To determine whether leptin and LH secretion in normal women is related to changes in metabolic rate. SETTING: Academic medical center. PATIENT(S) AND DESIGN: Ten young women with normal weight and menses were studied during the early follicular ... Full text Link to item Cite

Treatment of anorexia nervosa is associated with increases in bone mineral density, and recovery is a biphasic process involving both nutrition and return of menses.

Journal Article Am J Clin Nutr · July 2007 BACKGROUND: Recovery from osteoporosis in anorexia nervosa (AN) is uncertain. OBJECTIVE: The purpose of this study was to understand the changes in bone mineral density (BMD) in women with AN and the mechanisms of recovery from osteopenia. DESIGN: We studi ... Full text Link to item Cite

Bone density and amenorrhea in ballet dancers are related to a decreased resting metabolic rate and lower leptin levels.

Journal Article J Clin Endocrinol Metab · June 2002 Osteopenia, which is correlated with amenorrhea and poor nutritional habits, has been well documented in elite ballet dancers. Estrogen replacement therapy and recovery from amenorrhea have not been associated with normalization of bone density. Thus, the ... Full text Link to item Cite

Use of alternative therapies in menopause.

Journal Article Best Pract Res Clin Obstet Gynaecol · June 2002 Hormone replacement therapy has traditionally been used to treat the accompanying symptoms of oestrogen deficiency in menopause. However, not all women can, or prefer to, receive this treatment and alternatives should be considered to reduce the increased ... Full text Link to item Cite