Scholars@Duke
Terrence Kelburn Allen

Terrence Kelburn Allen

Associate Professor of Anesthesiology
Anesthesiology, Women's
terrence.allen@duke.edu
Box 3094 Med Ctr, Durham, NC 27710
2301 Erwin Road, 5662B Hafs Building, Durham, NC 27710

Selected Publications

CT-001, a novel fast-clearing factor VIIa, enhanced the hemostatic activity in postpartum samples.

Journal Article Blood Adv · January 23, 2024 The hemostatic system is upregulated to protect pregnant mothers from hemorrhage during childbirth. Studies of the details just before and after delivery, however, are lacking. Recombinant factor VIIa (rFVIIa) has recently been granted approval by the Euro ... Full text Link to item Cite

Duration of exposure to epidural anesthesia at delivery, DNA methylation in umbilical cord blood and their association with offspring asthma in Non-Hispanic Black women.

Journal Article Environ Epigenet · 2023 Epidural anesthesia is an effective pain relief modality, widely used for labor analgesia. Childhood asthma is one of the commonest chronic medical illnesses in the USA which places a significant burden on the health-care system. We recently demonstrated a ... Full text Link to item Cite

Evaluating the Association Between Fibrinogen and Rotational Thromboelastometry and the Progression to Severe Obstetric Hemorrhage.

Journal Article Clin Appl Thromb Hemost · 2023 AIM: This study aims to investigate the ability of fibrinogen and rotational thromboelastometry (ROTEM) parameters measured at obstetric hemorrhage protocol initiation to predict severe hemorrhage. METHODS: In this retrospective study we included patients ... Full text Link to item Cite

Associations between maternal obesity, gestational cytokine levels and child obesity in the NEST cohort.

Journal Article Pediatr Obes · July 2021 BACKGROUND: Although maternal systemic inflammation is hypothesized to link maternal pre-pregnancy obesity to offspring metabolic dysfunction, patient empirical data are limited. OBJECTIVES: In this study, we hypothesized that pre-pregnancy obesity alters ... 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

Systematic review of viscoelastic testing (TEG/ROTEM) in obstetrics and recommendations from the women's SSC of the ISTH.

Journal Article J Thromb Haemost · August 2020 Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are point-of-care viscoelastic devices that use whole blood samples to assess coagulation and fibrinolysis. These devices have been studied extensively in cardiac surgery, but there is lim ... Full text Link to item Cite

The association between neuraxial anesthesia and the development of childhood asthma - a secondary analysis of the newborn epigenetics study cohort.

Journal Article Curr Med Res Opin · June 2020 Objectives: Childhood asthma is a common chronic illness that has been associated with mode of delivery. However, the effect of cesarean delivery alone does not fully account for the increased prevalence of childhood asthma. We tested the hypothesis that n ... Full text Link to item Cite

Functional Genomics of Healthy and Pathological Fetal Membranes.

Journal Article Front Physiol · 2020 Premature preterm rupture of membranes (PPROM), rupture of fetal membranes before 37 weeks of gestation, is the leading identifiable cause of spontaneous preterm births. Often there is no obvious cause that is identified in a patient who presents with PPRO ... Full text Link to item Cite

Progestins Inhibit Interleukin-1β-Induced Matrix Metalloproteinase 1 and Interleukin 8 Expression via the Glucocorticoid Receptor in Primary Human Amnion Mesenchymal Cells.

Journal Article Front Physiol · 2020 Preterm premature rupture of membranes is a leading cause of preterm births. Cytokine induced matrix metalloproteinase1 and interleukin 8 production from amnion mesenchymal cells may contribute to fetal membrane weakening and rupture. Progestins inhibit in ... Full text Link to item Cite

Progestins Inhibit Tumor Necrosis Factor α-Induced Matrix Metalloproteinase 9 Activity via the Glucocorticoid Receptor in Primary Amnion Epithelial Cells.

Journal Article Reprod Sci · September 2019 Progestins have been recommended for preterm birth prevention in high-risk women; however, their mechanism of action still remains an area of debate. Medroxyprogesterone acetate (MPA) has previously been shown to significantly inhibit tumor necrosis factor ... Full text Link to item Cite

Roles of Progesterone Receptor Membrane Component 1 in Oxidative Stress-Induced Aging in Chorion Cells.

Journal Article Reprod Sci · March 2019 INTRODUCTION: Oxidative stress-mediated fetal membrane cell aging is activated prematurely in preterm premature rupture of membranes (PPROMs). The mechanism of this phenomenon is largely understudied. Progesterone receptor membrane component 1 (PGRMC1) has ... Full text Link to item Cite

Infection-induced thrombin production: a potential novel mechanism for preterm premature rupture of membranes (PPROM).

Journal Article Am J Obstet Gynecol · July 2018 BACKGROUND: Preterm premature rupture of membranes is a leading contributor to maternal and neonatal morbidity and death. Epidemiologic and experimental studies have demonstrated that thrombin causes fetal membrane weakening and subsequently preterm premat ... Full text Open Access 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

The impact of neuraxial clonidine on postoperative analgesia and perioperative adverse effects in women having elective Caesarean section-a systematic review and meta-analysis.

Journal Article Br J Anaesth · February 2018 Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review a ... Full text Link to item Cite

The Oxytocin Product Correlates with Total Oxytocin Received during Labor: A Research Methods Study.

Journal Article Am J Perinatol · January 2018 OBJECTIVE: Total dose of oxytocin received during labor is an important variable in studies of human labor but is difficult to calculate. We sought to identify a surrogate measure for total dose of oxytocin received. STUDY DESIGN: For each subject receivin ... Full text Link to item Cite

Global disparities in maternal morbidity and mortality.

Journal Article Semin Perinatol · August 2017 The disparity in maternal mortality for African American women remains one of the greatest public health inequities in the United States (US). To better understand approaches toward amelioration of these differences, we examine settings with similar dispar ... Full text Link to item Cite

A retrospective comparison of programmed intermittent epidural bolus with continuous epidural infusion for maintenance of labor analgesia.

Journal Article Curr Med Res Opin · August 2016 OBJECTIVE: To assess whether maintenance of labor epidural analgesia using programmed intermittent epidural bolus (PIEB) is associated with reduced local anesthetic (LA) consumption, patient-controlled epidural analgesia (PCEA) use, and rescue analgesia re ... Full text Link to item Cite

The Role of Progesterone and a Novel Progesterone Receptor, Progesterone Receptor Membrane Component 1, in the Inflammatory Response of Fetal Membranes to Ureaplasma parvum Infection.

Journal Article PLoS One · 2016 Ureaplasma parvum (U. parvum) is gaining recognition as an important pathogen for chorioamnionitis and preterm premature rupture of membranes. We aimed to investigate the roles of progesterone (P4) and a novel progesterone receptor, progesterone receptor m ... Full text Link to item Cite

The Effect of Progestins on Tumor Necrosis Factor α-Induced Matrix Metalloproteinase-9 Activity and Gene Expression in Human Primary Amnion and Chorion Cells In Vitro.

Journal Article Anesth Analg · May 2015 BACKGROUND: Current treatment modalities for preventing preterm premature rupture of membranes are limited, but progestins may play a role. Tumor necrosis factor α (TNFα) enhances matrix metalloproteinase-9 (MMP-9) gene expression and activity in fetal mem ... Full text Link to item Cite

Anesthetic management and outcomes of parturients with dilated cardiomyopathy in an academic centre.

Journal Article Can J Anaesth · March 2015 PURPOSE: This study examines the peripartum anesthetic management and outcomes of women with dilated cardiomyopathy in a large university medical centre over a seven-year period. PRINCIPAL FINDINGS: Twenty-five women were included in this series, 18 with a ... Full text Link to item Cite

Progesterone receptor membrane component 1 as the mediator of the inhibitory effect of progestins on cytokine-induced matrix metalloproteinase 9 activity in vitro.

Journal Article Reprod Sci · February 2014 Progesterone (P4) and the progestin, 17α-hydroxyprogesterone caproate, are clinically used to prevent preterm births (PTBs); however, their mechanism of action remains unclear. Cytokine-induced matrix metalloproteinase 9 (MMP-9) activity plays a key role i ... 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

The peripartum management of a patient with glutaric aciduria type 1.

Journal Article J Clin Anesth · March 2013 The management of cesarean delivery for a parturient with placenta previa at 36 weeks' gestation and glutaric aciduria type 1 is presented. The management goal was to prevent encephalopathic crisis by ensuring adequate caloric intake with dextrose infusion ... Full text Link to item Cite

Antiemetics added to phenylephrine infusion during cesarean delivery: a randomized controlled trial.

Journal Article Obstet Gynecol · March 2013 OBJECTIVE: To estimate whether the addition of metoclopramide or its combination with ondansetron to a prophylactic phenylephrine infusion provides improved intraoperative nausea and vomiting prophylaxis compared with phenylephrine infusion alone. METHODS: ... Full text Link to item Cite

Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis.

Journal Article Br J Anaesth · February 2013 BACKGROUND: The analgesic efficacy and adverse effects of a single perioperative dose of dexamethasone are unclear. We performed a systematic review to evaluate the impact of a single i.v. dose of dexamethasone on postoperative pain and explore adverse eve ... Full text Link to item Cite

Intermittent epidural bolus compared with continuous epidural infusions for labor analgesia: a systematic review and meta-analysis.

Journal Article Anesth Analg · January 2013 BACKGROUND: The current standard labor epidural analgesic regimens consist of a local anesthetic in combination with an opioid delivered via continuous epidural infusion (CEI). With CEI local anesthetic, doses may be large with resulting profound motor blo ... Full text Link to item Cite

Hypertensive disease in pregnancy: an examination of ethnic differences and the Hispanic paradox.

Journal Article J Neonatal Perinatal Med · 2013 OBJECTIVE: The "Hispanic paradox" refers to the epidemiological finding that Hispanics in the US have better health outcomes than the average population despite what their aggregate socioeconomic determinants would predict. The aim of this study was to eva ... Full text Link to item Cite

Dexamethasone for the prophylaxis of postoperative nausea and vomiting associated with neuraxial morphine administration: a systematic review and meta-analysis.

Journal Article Anesth Analg · April 2012 BACKGROUND: We performed a systematic review to assess the efficacy of dexamethasone in reducing postoperative nausea, vomiting (PONV), pruritus, and enhancing postoperative analgesia in patients receiving neuraxial anesthesia with neuraxial morphine. METH ... Full text Link to item Cite

Peripartum management of two parturients with ornithine transcarbamylase deficiency.

Journal Article Int J Obstet Anesth · January 2012 Ornithine transcarbamylase deficiency is a rare X-linked disorder in which female carriers are usually heterozygous for the ornithine transcarbamylase deficiency gene. In pregnancy it has been associated with altered mental status, seizures, coma and death ... Full text Link to item Cite

Remifentanil for fetal immobilization and analgesia during the ex utero intrapartum treatment procedure under combined spinal-epidural anaesthesia.

Journal Article Br J Anaesth · June 2011 Remifentanil undergoes extensive placental transfer and has been used to provide fetal immobilization and anaesthesia for in utero fetal endoscopic interventions. We report three cases of the ex utero intrapartum treatment performed under neuraxial anaesth ... Full text Link to item Cite

Analgesic and antiemetic needs following minimally invasive vs open staging for endometrial cancer.

Journal Article Am J Obstet Gynecol · January 2011 OBJECTIVE: We sought to assess perioperative outcomes of minimally invasive vs open endometrial cancer staging procedures. STUDY DESIGN: A total of 181 consecutive patients underwent open or minimally invasive hysterectomy with or without lymphadenectomy. ... Full text Link to item Cite

A double-blind, placebo-controlled trial of four fixed rate infusion regimens of phenylephrine for hemodynamic support during spinal anesthesia for cesarean delivery.

Journal Article Anesth Analg · November 2010 BACKGROUND: The administration of prophylactic phenylephrine infusions in combination with fluid cohydration significantly reduces the incidence of hypotension in women having cesarean delivery under spinal anesthesia. The ideal dosing regimen for this pur ... Full text Link to item Cite

Minimum effective dose of spinal ropivacaine with and without fentanyl for postpartum tubal ligation.

Journal Article Int J Obstet Anesth · October 2010 BACKGROUND: Ropivacaine may be the ideal spinal anesthetic for postpartum tubal ligation due to its medium duration of action, low incidence of side effects and possibly reduced post-anesthetic care unit (PACU) stay. METHODS: Two prospective up-down sequen ... Full text Link to item Cite

A survey of the management of spinal-induced hypotension for scheduled cesarean delivery.

Journal Article Int J Obstet Anesth · October 2009 BACKGROUND: Intravenous fluids and vasopressors are used for managing spinal-induced hypotension during cesarean delivery, but the choice of vasopressor and the type and timing of fluid administration remain controversial. METHODS: We conducted an electron ... Full text Link to item Cite

Serotonin receptor antagonists for the prevention and treatment of pruritus, nausea, and vomiting in women undergoing cesarean delivery with intrathecal morphine: a systematic review and meta-analysis.

Journal Article Anesth Analg · July 2009 BACKGROUND: We performed a systematic review to determine the overall efficacy of serotonin (5-HT3) receptor antagonists for the prevention and treatment of pruritus, nausea, and vomiting in women receiving spinal anesthesia with intrathecal morphine for c ... Full text Link to item Cite

P6 stimulation for the prevention of nausea and vomiting associated with cesarean delivery under neuraxial anesthesia: a systematic review of randomized controlled trials.

Journal Article Anesth Analg · October 2008 BACKGROUND: A number of studies investigated the use of P6 stimulation for the prevention of intraoperative and postoperative nausea and vomiting (IONV and PONV) in women having cesarean delivery under neuraxial anesthesia. We performed a systematic review ... Full text Link to item Cite

Multidisciplinary management of placenta percreta complicated by embolic phenomena.

Journal Article Int J Obstet Anesth · July 2008 Hemorrhage and thrombosis are major causes of maternal mortality. This case discusses the management of a woman with placenta percreta complicated by intraoperative pulmonary embolism. A 39-year-old gravida 3 with two previous cesarean deliveries presented ... Full text Link to item Cite

Brief report: a randomized controlled trial of Synera versus lidocaine for epidural needle insertion in labouring parturients.

Journal Article Can J Anaesth · March 2008 PURPOSE: Skin infiltration with lidocaine, although brief, can be very stressful, painful, and may perpetuate anxiety. Synerat, a local anesthetic patch, which contains an oxygen-activated heating component to enhance the delivery of a eutectic mixture of ... Full text Link to item Cite

Management of a parturient with an acute exacerbation of idiopathic pulmonary haemosiderosis and posterior spinal instrumentation.

Journal Article Br J Anaesth · February 2008 Idiopathic pulmonary haemosiderosis (IPH) is a rare condition associated with diffuse alveolar haemorrhage and pulmonary fibrosis. We describe the anaesthetic management of a parturient with a history of posterior spinal fusion presenting with an acute exa ... Full text Link to item Cite

A pilot study to compare the Episure Autodetect syringe with the glass syringe for identification of the epidural space in parturients.

Journal Article Anesth Analg · February 2008 The Episure AutoDetect syringe, a spring-loaded syringe, is a new loss-of-resistance syringe with an internal compression spring that applies constant pressure on the plunger. In this pilot study, we compared the spring-loaded syringe with the standard gla ... Full text Link to item Cite

How much are patients willing to pay to avoid postoperative muscle pain associated with succinylcholine?

Journal Article J Clin Anesth · December 2007 STUDY OBJECTIVE: To determine how much money patients are willing to pay to avoid postoperative muscle pains associated with succinylcholine. DESIGN: Observational study with survey instrument. SETTING: University-affiliated metropolitan hospital. PATIENTS ... Full text Link to item Cite

Anaesthetic management of a woman with autosomal recessive limb-girdle muscular dystrophy for emergency caesarean section.

Journal Article Int J Obstet Anesth · October 2007 We report the successful management of a 28-year-old parturient with an autosomal recessive limb-girdle muscular dystrophy with severe restrictive lung disease, who required non-invasive positive pressure ventilation in the third trimester of her pregnancy ... Full text Link to item Cite

The management of Cesarean delivery in a parturient with paroxysmal nocturnal hemoglobinuria complicated by severe preeclampsia.

Journal Article Can J Anaesth · August 2007 PURPOSE: To describe the anesthetic and peripartum management of a parturient with paroxysmal nocturnal hemoglobinuria complicated by severe preeclampsia, review the pathophysiology of this condition, rationale for thromboembolic prophylaxis, and its impli ... Full text Link to item Cite

The vanishing heart - A useful sign in ARDS

Journal Article British Journal of Intensive Care · June 1, 2006 Chest X-rays in acute respiratory distress syndrome (AROS) may highlight radiological abnormalities of varying clinical significance. In fact, up to 65% of daily radiographs in intensive care units (ICUs) reveal some significant or unsuspected abnormalitie ... Cite