Comparison of the Hemodynamic Alterations in Normotensive and Preeclamptic Pregnant Woman Posted for Cesarean Section Under Subarachnoid Block

Mitra, Manasij; Basu, Dipanwita

doi:10.4172/2329-9517.1000242

Cited by 7 publications

(18 citation statements)

References 27 publications

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“…This result was in line with Nikooseresht M et al [12]. Similar to a study done by Lavie A et al [24], in our study, the total estimated blood loss was comparable between groups, and no blood products were required throughout the procedure. Nikooseresht M et al also found that the surgical durations were comparable between two groups [12].…”

Section: Discussionsupporting

confidence: 93%

“…The discrepancy in the incidence of hypotension Following spinal anesthesia, the mean SBP, DBP, and MAP measured at different time points were higher in preeclamptic parturients than the corresponding values among non-preeclamptic parturients. But this difference was insignificant between groups at 14,18,22,24,26,35 min in SBP, at 8 and 40 min in DBP, at 10, 14, 24, 35 min in MAP, and thereafter to the end of surgery. Whereas, the mean pulse rate was comparable between groups at different time points after SA.…”

Section: Discussionmentioning

confidence: 82%

“…Preeclampsia with severity feature/severe preeclampsia: Defined as a systolic arterial blood pressure of 160 mmHg or higher, or a diastolic blood pressure of 110 mmHg or higher, associated with proteinuria > 5 g in 24 h [12,23]. Change in heart rate: When there was a 20% decrease or increase in heart rate from baseline [6,12,22,24,25]. The magnitude of hemodynamics change/severity of hypotension: The percentage falls of blood pressure (SBP, DBP, and MAP) between two measurements and it was calculated as [12,22,26]:…”

Section: Intraoperative Hypotensionmentioning

confidence: 99%

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Hemodynamic changes after spinal anesthesia in preeclamptic patients undergoing cesarean section at a tertiary referral center in Ethiopia: a prospective cohort study

et al. 2020

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Background: Spinal anesthesia-induced maternal hypotension is the most frequent complication associated with maternal morbidity and mortality during Cesarean section. The aim of this study was to compare the incidence and magnitude of hemodynamic changes in preeclamptic and non-preeclamptic parturients undergone Cesarean section under spinal anesthesia. Method: A prospective cohort study was conducted from 01 February to 28 May 2019 in preeclamptic and nonpreeclamptic parturients. We hypothesized preeclamptic parturients are at high risk of spinal anesthesia induced hypotension than non preeclamptics. A total of 122 ASA II and ASA III parturients were recruited consecutively and assigned to two groups (81non-preeclamptics, and 41 preeclamptics). Parturients with cardiac disease, twin pregnancy, chronic hypertension, gestational hypertension, superimposed hypertension, renal disease, diabetes mellitus, coagulopathy (platelet count < 80 × 10 9 /L), active labor, eclampsia, abruptio placentae, placenta praevia, any adjuvant added with local anesthetics were excluded. The data analysis was done using SPSS version 22 statistical software. Student t test, MannWhitney U test and Fisher exact test were used to compare the data. All P values < 0.05 were considered statistically significant. Result: The incidence of spinal anesthesia-induced hypotension was higher in non-preeclamptic parturients than preeclamptic parturients (55.6% vs. 34.1%, respectively) and the degree of blood pressure drop was significantly greater in the non-preeclamptic parturients compared to those with preeclampsia; As well intraoperative fluid consumption was significantly greater in the non-preeclamptics parturients compared to those with preeclamptics. Conclusion: The incidence and magnitude of spinal anesthesia-induced hypotension in parturients undergone Cesarean section were less in preeclamptic parturients than in non-preeclamptic parturients.. Based on the data from this study we recommended spinal anesthesia for preeclamptic patients, unless there is a contra indication based on preeclampsia.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 82%

Section: Intraoperative Hypotensionmentioning

confidence: 99%

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Hemodynamic changes after spinal anesthesia in preeclamptic patients undergoing cesarean section at a tertiary referral center in Ethiopia: a prospective cohort study

et al. 2020

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“…Whereas, the mean pulse rate was comparable between groups at different time points after SA. Mitra M et al found significant differences in SBP, DBP, and MAP at each point of time in both groups [37]. The possible explanation for this discrepancy might be the employment of invasive blood pressure monitoring in their study, in contrast to our study.…”

Section: Discussioncontrasting

confidence: 84%

“…However, this difference was not statistically significant (p =0.550). Even though our study does not quantify it, studies found that hypotension requiring vasopressor medication(ephedrine and phenylephrine) following spinal anesthesia was less common in parturients with preeclampsia than in non-preeclamptic parturients [12,17,25,37,38,41,42]. The limitation of this study was the small sample size, observational study design which was difficult to control all possible cofounders(like oxytocin), and inability to quantify vasopressor consumption; due to lack of standardized vasopressor(ephedrine and phenylephrine)usage in the practice, which could affect the trends of hemodynamic change over time.…”

Section: Vs1653 Ml±331)mentioning

confidence: 85%

Comparison of hemodynamic change following spinal anesthesia in preeclamptic and non-preeclamptic parturients undergoing cesarean section at University of Gondar comprehensive specialized hospital, Northwest Ethiopia.

Yetneberk

Berhe

Getnet

et al. 2020

Preprint

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Background Spinal anesthesia-induced maternal hypotension is the most frequent complication associated with maternal morbidity and mortality during cesarean section. The aim of this study was to compare the incidence and magnitude of hemodynamic changes in preeclamptic and non-preeclamptic parturients undergone cesarean section under spinal anesthesia. Method A prospective cohort study was conducted from February to May 2019 in University of Gondar comprehensive specialized hospital. A total of 122 ASA II and ASA III parturients were recruited consecutively and assigned to two groups (81non-preeclamptics, and 41 preeclamptics). The data analysis was done by SPSS version 22 statistical software. The data were tested for normality with Shapiro Wilk U-test and normally distributed data were compared by using the independent student’s t-test. Whereas non-normally distributed data were compared using the Mann-Whitney U- test. Fisher’s exact test was used for intergroup comparison of proportion. All P values <0.05 were considered statistically significant. Result The incidence of spinal anesthesia-induced hypotension was higher in non-preeclamptic parturients than preeclamptic parturients (55.6% vs. 34.1%, respectively) and the degree of blood pressure drop was significantly greater in the non-preeclamptic parturients compared to those with preeclampsia; As well intraoperative fluid consumption was significantly greater in the non-preeclamptics parturients compared to those with preeclamptics. Conclusion The incidence and magnitude of spinal anesthesia-induced hypotension in parturients undergone cesarean section were less in preeclamptic parturients than in non-preeclamptic parturients. Therefore, don’t deny spinal anesthesia for preeclamptic parturients due to fear of profound hypotension, unless there is a contraindication for spinal anesthesia.

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Maternal and neonatal outcomes of preeclamptic and normotensive women who underwent cesarean section under spinal Anesthesia: Systematic review and Meta-Analysis

Abate

Mergia

Basu

2020

Preprint

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Background: preeclampsia is very challenging for anesthetists due to the heterogeneous clinical spectrum of the disease characterized by hypertension, risk of hypotension, high risk of aspiration, and difficult airway. Therefore, the Meta-Analysis is intended to provide evidence on maternal and neonatal outcomes of preeclamptic parturient. Methods: A comprehensive strategy was conducted in PubMed/Medline, Science Direct, and Cochrane from January 2000 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot and I2 test. Observational and experimental studies reporting maternal and neonatal outcomes among preeclamptic and normotensive women were included. Results: The Meta-Analysis revealed that pooled incidence of hypotension was reduced by thirty-eight percent in preeclamptic as compared to normotensive parturient, RR=0.62(95% confidence interval (CI): 0.52 to 0.75)Conclusion: The Meta-Analysis revealed that the incidence of hypotension was lower in preeclamptic women when compared to normotensive women. The included studies were low to a very low quality of evidence which entails further randomized controlled trials.Registration: This systematic review and meta-analysis was registered in Open science Network on June 6, 2020, and the registration is available at https://osf.io/jcedt/.

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Comparison of the Hemodynamic Alterations in Normotensive and Preeclamptic Pregnant Woman Posted for Cesarean Section Under Subarachnoid Block

Cited by 7 publications

References 27 publications

Hemodynamic changes after spinal anesthesia in preeclamptic patients undergoing cesarean section at a tertiary referral center in Ethiopia: a prospective cohort study

Hemodynamic changes after spinal anesthesia in preeclamptic patients undergoing cesarean section at a tertiary referral center in Ethiopia: a prospective cohort study

Comparison of hemodynamic change following spinal anesthesia in preeclamptic and non-preeclamptic parturients undergoing cesarean section at University of Gondar comprehensive specialized hospital, Northwest Ethiopia.

Maternal and neonatal outcomes of preeclamptic and normotensive women who underwent cesarean section under spinal Anesthesia: Systematic review and Meta-Analysis

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