scholarly journals Comparison of three neuraxial anesthesia approaches in parturient women with obesity and pregnancy-induced hypertension who underwent cesarean section

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110664
Author(s):  
Jie Li ◽  
An-er Chen ◽  
Ren Ye
Keyword(s):  
Mean Arterial Pressure ◽  
Cesarean Section ◽  
Arterial Pressure ◽  
Epidural Anesthesia ◽  
Neuraxial Anesthesia ◽  
Pregnancy Induced Hypertension ◽  
Apgar Scores ◽  
Intraoperative Hypotension ◽  
Induced Hypertension ◽  
Change In Mean

Objective To compare the effectiveness of different approaches of neuraxial anesthesia in parturient women with obesity and pregnancy-induced hypertension (PIH) who undergo cesarean section (CS). Methods We retrospectively analyzed data from 108 parturient women with obesity and PIH who underwent CS. All women were divided into the following three groups according to the neuraxial anesthesia approach: spinal anesthesia (SA), epidural anesthesia (EA), and combined spinal–epidural anesthesia (CSE). Clinical variables were compared. Results The mean age of the patients was 27.3 ± 2.2 years. Women in the CSE group had a longer duration from puncture to surgery, smaller intraoperative change in mean arterial pressure, higher Apgar scores at 1 and 5 minutes, shorter surgery time, lower rates of nausea and vomiting, and lower rate of intraoperative hypotension compared with those in the SA and EA groups. Conclusion CSE takes longer to administer in parturient women with obesity and PIH who undergo CS compared with those who have SA or EA. However, CSE has several advantages over SA or EA, including a shorter surgery time, more stable intraoperative mean arterial pressure, lower rates of nausea, vomiting, and intraoperative hypotension, and better Apgar scores at 1 and 5 minutes.

scholarly journals Relationship between Abdominal Circumference and Incidence of Hypotension during Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Pattaraleeya Thomard ◽  
Sunthiti Morakul ◽  
Nichawan Wirachpisit ◽  
Wichai Ittichaikulthol ◽  
Chawika Pisitsak
Keyword(s):  
Mean Arterial Pressure ◽  
Cesarean Section ◽  
Arterial Pressure ◽  
Spinal Anesthesia ◽  
Vena Cava ◽  
Abdominal Circumference ◽  
Study Cohort ◽  
Percentage Decrease ◽  
Change In Mean ◽  
The Relationship

Background. Enlarged uterus can compress the inferior vena cava and cause hypotension when lying supine. Previous studies have shown a positive association between the abdominal circumference and size of the uterus. Therefore, the aim of this study was to evaluate the relationship between abdominal circumference and incidence of hypotension during cesarean section under spinal anesthesia. Methods. The study cohort comprised women undergoing cesarean section under spinal anesthesia. Patients were divided into two groups according to the median abdominal circumference (<101 cm and ≥101 cm). Hypotension was defined as a systolic blood pressure of <90 mmHg or mean arterial pressure of <65 mmHg. The primary outcome of this study was the relationship between the incidence of hypotension and the abdominal circumference after spinal anesthesia in term pregnant women. Results. The study cohort comprised 100 women. The incidence of hypotension did not differ between the groups (71.42% in the smaller vs. 78.43% in the larger abdominal circumference group, p=0.419). However, the decrease in mean arterial pressure and its percentage decrease from baseline were greater in the larger than in the smaller abdominal circumference group (change in mean arterial pressure: 28.33 mmHg (18.66–33.67) in the smaller vs. 36.67 mmHg (23.34–43.34) in the larger abdominal circumference group, p=0.004; percentage decrease: 31.41% (22.74–39.22) in the smaller vs. 38.47% (28.00–44.81) in the larger abdominal circumference group, p=0.022). Conclusions. Large abdominal circumference in pregnancy is associated with greater decreases in mean arterial pressure from baseline. However, the incidence of hypotension defined by standard criteria did not differ between larger and smaller abdominal circumference groups.

PATTERN OF MEAN ARTERIAL PRESSURE DURING THE COURSE OF PREGNANCY

2021 ◽  
pp. 70-71
Author(s):  
A. Kala
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Urban Population ◽  
Sedentary Lifestyle ◽  
Pregnancy Induced Hypertension ◽  
Serial Measurement ◽  
Induced Hypertension ◽  
Increasing Trend ◽  
Duration Of Pregnancy

Background and Objectives: The incidence of Pregnancy Induced Hypertension is in increasing trend nowadays due to sedentary lifestyle during pregnancy and also due to various other factors. The aim of this study is to measure the incidence of PIH in a semi urban population of Tirunelveli town and to know the correlation between failure of a mid-trimester dip in mean arterial pressure and development of PIH later in pregnancy by serial measurement of blood pressure starting from rst trimester until delivery of the baby. Main objective is to nd out whether failure of mid trimester fall in blood pressure can be used as a predictor for development of PIH. Materials and Methods: About 100 pregnant women in their early pregnancy i.e. 6 to 7 weeks pregnancy were selected from semi urban population of Tirunelveli town. These women were selected while attending Kandiaperi Government Hospital which is located in Tirunelveli town. Serial measurement of blood pressure done using standard sphygmomanometer once in every two weeks until delivery and mean arterial pressure calculated. Pattern of mean arterial pressure noted in every visit, incidence of PIH noted and correlation between failure of dip in MAP in mid trimester and development of PIH analyzed. Incidence of PIH was 5%. Dip in Results: mean arterial pressure at mid trimester was not signicant. There was an increasing trend of mean arterial pressure as duration of pregnancy advances. PIH is multifactorial. Failure Conclusion: of fall in mean arterial pressure in mid trimester alone cannot be used as a predictor of PIH.

Sign in / Sign up

Export Citation Format

Share Document