scholarly journals Effect of transdermal nitroglycerin patch on severe preeclamptic women with abnormal Doppler indices

2019 ◽  
Vol 8 (2) ◽  
pp. 597
Author(s):  
El-Sayed S. El-Ebshehy ◽  
Ahmed M. Hagras ◽  
Amr T. Elbadry ◽  
Ahmed M. Awara
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Maternal Blood ◽  
Placental Insufficiency ◽  
University Hospitals ◽  
Singleton Pregnancy ◽  
Arterial Blood ◽  
Risk Pregnancy ◽  
Doppler Indices ◽  
Maternal Blood Pressure

Background: The aim is to evaluate the effect of maternal transdermal nitro-glycerine patch administration on blood flow resistance on maternal uterine artery, fetal umbilical and middle cerebral arteries in patients with severe pre-eclampsia in early gestational age (24 weeks to 33 weeks) associated with abnormal Doppler indices (placental insufficiency) and also its effect on maternal mean arterial blood pressure.Methods: This is a prospective interventional clinical trial conducted on (50) pregnant women with singleton pregnancy diagnosed with severe pre-eclampsia admitted in high-risk pregnancy unit at the Department of Obstetrics  in Tanta University Hospitals, A 50-mg transdermal GTN patch (Novartis Pharma) was applied to the abdominal skin, releasing nitroglycerin at a rate of 0.4 mg/h. Doppler ultrasonography and measurement of maternal blood pressure were performed before application of transdermal GTN patch, after 4 hours of application, after 24 hours and after 48 hours.Results: the application of a 50-mg transdermal GTN patch to the maternal abdomen was associated with a significant decline in the PI of the uteroplacental and fetoplacental blood flow. No change was observed in the PI of the cerebral circulation. And also, there was a significant decrease in maternal blood pressure (MAP).Conclusions: Nitroderm patch (nitric oxide donors) may be used as initial therapy in cases of severe preeclampsia complicated by placental insufficiency in the form of abnormal Doppler indices.

EFFICACY OF PHENYLEPHRINE AND EPHEDRINE IN MAINTAINING MATERNAL BLOOD PRESSURE INTRA OPERATIVELY DURING SPINAL ANESTHESIA FOR CAESAREAN SECTION

2021 ◽  
pp. 25-28
Author(s):  
Anant Prakash ◽  
Rahul Kumar ◽  
Chandeshwar Choudhary ◽  
Debarshi Jana
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Rapid Onset ◽  
Maternal Blood ◽  
Emergency Caesarean Section ◽  
Singleton Pregnancy ◽  
Duration Of Action ◽  
Arterial Blood ◽  
Maternal Blood Pressure

Introduction: Spinal anaesthesia has become a popular technique for caesarean section. It however has the potential to cause rapid onset of maternal hypotension which may have detrimental maternal and neonatal effects. Thus, a number of strategies for treating hypotension have been investigated. Careful positioning and volume preloading with crystalloid or colloids have been used to prevent it, but these are not complete measures and vasopressor is required to correct hypotension quickly . Methodology: 100 parturients ASA I and II scheduled for elective as well as emergency Caesarean section under sub arachnoid block (SAB) were studied. All parturients were at term, had uncomplicated singleton pregnancy with cephalic presentation. Results: Phenylephrine and Ephedrine are effective given prophylactically IV bolus followed by infusion in maintenance of arterial pressure within 15% limit of baseline. Phenylephrine has quicker and shorter duration of action effect in comparison to Ephedrine. Conclusion: Vasopressor drugs Phenylephreine and Ephedrine, effectively maintained arterial blood pressure during spinal anaesthesia for caesarean section

Norepinephrine versus Ephedrine Boluses To Treat Spinal-Induced Hypotension in Cesarean Deliveries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed M Abo Kamar ◽  
Manal M Shams ◽  
Mai M AbdelAziz ◽  
Wessam Z Selima
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Hypotensive Effect ◽  
Maternal Blood ◽  
Neurological Injury ◽  
Maternal Complications ◽  
Placental Blood ◽  
Maternal Blood Pressure

Abstract Corresponding Background Cesarean sections normally require an anesthetic block at T4 level, so hypotension is reported to occur in up to 80% of spinal anesthesia cases. When maternal hypotension associated with spinal anesthesia for cesarean section is severe and sustained, it can lead to serious maternal complications as well as impairment of the uterine and placental blood flow with consecutive fetal hypoxia, acidosis, and neurological injury. Aim of the Work to compare the administration of intermittent i.v. boluses of norepinephrine and ephedrine to counterbalance the hypotensive effect of spinal anesthesia during cesarean delivery. The results of the study showed that compared with ephedrine, norepinephrine maintained maternal blood pressure and uterine artery blood flow. Further, it was associated with lower numbers of hypotension and hypertension episodes and less frequency of bradycardia and tachycardia during cesarean delivery. Furthermore, the numbers of boluses of vasopressors used during spinal anesthesia were lower in norepinephrine compared with the use of ephedrine. Conclusion Norepinephrine can be used as an alternative vasopressor to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, with no adverse effect on neonatal outcome.

Magnesium Sulfate Decreases Maternal Blood Pressure but Not Uterine Blood Flow during Epidural Anesthesia in Gravid Ewes

1991 ◽  
Vol 74 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Robert D. Vincent ◽  
David H. Chestnut ◽  
Susan L. Sipes ◽  
Carl P. Weiner ◽  
Craig S. DeBruyn ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Magnesium Sulfate ◽  
Epidural Anesthesia ◽  
Maternal Blood ◽  
Uterine Blood Flow ◽  
Maternal Blood Pressure

Does Calcium Chloride Help Restore Maternal Blood Pressure and Uterine Blood Flow During Hemorrhagic Hypotension in Hypermagnesemic Gravid Ewes?

1992 ◽  
Vol 74 (5) ◽  
pp. 670???676 ◽  
Author(s):  
Robert D. Vincent ◽  
David H. Chestnut ◽  
Susan L. Sipes ◽  
Craig S. DeBruyn ◽  
Papri Chatterjee ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Calcium Chloride ◽  
Maternal Blood ◽  
Uterine Blood Flow ◽  
Hemorrhagic Hypotension ◽  
Maternal Blood Pressure

OP 52 Sildenafil for the treatment of placental insufficiency – A preclinical meta-analysis on fetal growth and maternal blood pressure

2017 ◽  
Vol 9 ◽  
pp. 32
Author(s):  
Nina Paauw ◽  
Fieke Terstappen ◽  
Wessel Ganzevoort ◽  
Jaap Joles ◽  
Hendrik Gremmels ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Fetal Growth ◽  
Meta Analysis ◽  
Maternal Blood ◽  
Placental Insufficiency ◽  
Maternal Blood Pressure

Responses of fetal sheep to simulated no-decompression dives

1980 ◽  
Vol 48 (5) ◽  
pp. 776-780 ◽  
Author(s):  
M. K. Stock ◽  
E. H. Lanphier ◽  
D. F. Anderson ◽  
L. C. Anderson ◽  
T. M. Phernetton ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Maternal Blood ◽  
Arterial System ◽  
Fetal Sheep ◽  
Monitoring Result ◽  
Placental Blood ◽  
Near Term ◽  
Placental Blood Flow ◽  
Maternal Blood Pressure

The effect of simulated standard no-decompression dives to 60 and 100 ft of seawater was tested in 12 near term sheep carrying 16 fetuses. In the immediate postdive period there were no significant changes in fetal blood pressure or fetal placental or renal blood flow, but the maternal blood pressure was elevated and the maternal placental blood flow was depressed. Six surgically prepared fetuses were dived to 100 ft. Five died within 20 min of ascent and the sixth suffered severe cardiac arrhythmia and hypotension. At autopsy all fetuses were observed to have massive bubbling in the arterial system and heart. Five fetuses were dived to 100 ft without surgery. Two were alive 3 h later and no bubbles were present at autopsy, and three were born alive at term. With the 60-ft dives, three fetuses were subjected to surgery and all suffered massive bubbling. Two fetuses were dived to 60 ft without surgery; one was alive after 3 h and the other was born alive at term. We conclude that surgery and monitoring result in the formation of postdive gas bubbles that would not otherwise appear.

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