Are Standard Intra-Abdominal Pressure Values Different during Pregnancy?

Abstract

BackgroundMeasurement of intra-abdominal pressure (IAP) is an important parameter in the surveillance of intensive care unit patients. Standard values of IAP during pregnancy have not been well defined. The aim of this study was to assess IAP values in pregnant women before and after cesarean delivery.MethodsThis prospective study, carried out from January to December 2011 in a French tertiary care centre, included women with an uneventful pregnancy undergoing elective cesarean delivery at term. IAP was measured through a Foley catheter inserted in the bladder under spinal anaesthesia before cesarean delivery, and every 30 minutes during the first two hours in the immediate postoperative period.ResultsThe study included 70 women. Mean IAP before cesarean delivery was 14.2 mmHg (95%CI: 6.3–23). This value was significantly higher than in the postoperative period: 11.5 mmHg (95%CI: 5–19.7) for the first measurement (p = 0.002). IAP did not significantly change during the following two postoperative hours (p = 0.2). Obese patients (n = 25) had a preoperative IAP value significantly higher than non-obese patients: 15.7 vs. 12.4; p = 0.02.ConclusionIn term pregnancies, IAP values are significantly higher before delivery than in the post-partum period, where IAP values remain elevated for at least two hours at the level of postoperative classical abdominal surgery. The knowledge of these physiological changes in IAP values may help prevent organ dysfunction/failure when abdominal compartment syndrome occurs after cesarean delivery.

The effect of different types of abdominal binders on intra-abdominal pressure

“…Hemoperitoneum and pneumatosis can cause changes in IAV and eventually increase IAP. 12 , 20 The combined effect of the above factors may explain why postoperative IAP is higher than preoperative IAP.…”

Management of peripartum intra‐abdominal hypertension and abdominal compartment syndrome

“…Contemporary studies, displayed in Table , report that the mean IAP of term parturients ranges from 10.9 ± 4.7 to 17.8 ± 3.6 mm Hg . The IAP decreases to between 9.6 ± 0.89 and 10.7 mm Hg (standard deviation unavailable) by 24 hours postpartum .…”

“…4,9,[13][14][15] The IAP decreases to between 9.6 ± 0.89 and 10.7 mm Hg (standard deviation unavailable) by 24 hours postpartum. 4,[13][14][15][16] IAP in the immediate postpartum period remains higher than that found in nonpregnant patients and is position dependent, with lower pressure values recorded when supine. 16 Critically ill pregnant women have a mean IAP of 13.2 ± 2.2 mm Hg at the time of ICU admission, compared with postpartum ICU patients who have an IAP of 8.1 ± 1.5 mm Hg.…”

“…If unsuccessful, delivery is warranted.The IAP will drop shortly after delivery secondary to laparotomy decompression (if required) and normal postpartum decreases 4. Within 24 hours postpartum, IAP decreases to between 8.1 ± 1.5 and 10.7 mm Hg (standard deviation unavailable) 4,[13][14][15][16].…”

Progressive Functional Underdrainage in Cerebrospinal Fluid Shunt-Dependent Women During Pregnancy: Case Report and Review of the Literature

“…31 During pregnancy the IAP is chronically raised and quickly falls to regular levels after delivery. [32][33][34] Likewise, short peeks of IAP 35,36 do not seem to affect the ICP as vaginal delivery can be performed without complications. 1,2,6,9,10,12,[14][15][16][18][19][20]22,23,37 Future perspectives:…”