Lower limbs venous compression reduces the incidence of maternal hypotension following epidural analgesia during term labor

Peyronnet, Violaine; Roses, Arnaud; Girault, A.; Bonnet, Marie; Goffinet, François; Tsatsaris, Vassilis; Lecarpentier, Édouard

doi:10.1016/j.ejogrb.2017.10.016

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…151 In 2017, an investigation showed that 20-36 mmHg can be beneficial in reducing maternal hypotension following epidural analgesia. 152 A current lack of proper guidelines and thromboprophylactic measurements application has been reported in the OBGyn field in 2018. 153 Use of proper thrombo-embolic risk assessment tools have been recently proposed during pregnancy and puerperium demonstrating their efficacy in proper patient management.…”

Section: Ulcer Healing and Recurrence A Fundamental Paper Bymentioning

confidence: 99%

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Global guidelines trends and controversies in lower limb venous and lymphatic disease

et al. 2019

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Guidelines are fundamental in addressing everyday clinical indications and in reporting the current evidence-based data of related scientific investigations. At the same time, a spatial and temporal issue can limit their value. Indeed, variability in the recommendations can be found both among the same nation different scientific societies and among different nations/continents. On the other side, Garcia already published in 2014 data showing how, after three years in average, one out of five recommendations gets outdated (Martinez Garcia LM, Sanabria AJ, Garcia Alvarez E, et al. The validity of recommendations from clinical guidelines: a survival analysis. CMAJ 2014;186(16):1211–1219). The present document reports a narrative literature revision on the major international recommendations in lower limb venous and lymphatic disease management, focusing on the different countries’ guidelines, trends and controversies from all the continents, while identifying new evidence-based data potentially influencing future guidelines. World renowned experts’ opinions are also provided. The document has been written following the recorded round tables scientific discussions held at the vWINter international meeting (22–26 January 2019; Cortina d’Ampezzo, Italy) and the pre- and post-meeting literature search performed by the leading experts.

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Section: Ulcer Healing and Recurrence A Fundamental Paper Bymentioning

confidence: 99%

“…In 2017, an investigation showed that 20–36 mmHg can be beneficial in reducing maternal hypotension following epidural analgesia. 152…”

Section: Graduated Elastic Stockingsmentioning

confidence: 99%

Global guidelines trends and controversies in lower limb venous and lymphatic disease

et al. 2019

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“…In contrast to this study; Lee et al [24] who identified in their study carried out in U.S.A that there were no significant differences between groups in umbilical artery pH or Apgar scores. Also, Peyronneta et al [25] who reported that no Apgar scores were below 7 at 5th min and there were no significant differences among the groups in Apgar scores at the 5th minute (p = .43). Umbilical cord blood pH was not below 7.2 in any case and no significant difference was detected among the groups regarding fetal acidosis (p = .55) also, no significant difference was noted among the groups regarding NICU admission (p = .71).…”

Section: Discussionmentioning

confidence: 87%

Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

El-Shora

El-Nemer

2019

JNEP

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Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.

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“…To detect significant changes in maternal and fetal Doppler, larger studies are needed, with an adequately powered sample size. Although SCD is commonly used to prevent deep vein thrombosis in pregnant women, lower limb compression by SCD was previously shown to decrease the incidence of maternal hypotension in women receiving epidural anesthesia during term labor [14]. A Cochrane Review that included 11 studies concluded that lower limb compression is a safe and effective option in preventing maternal hypotension after spinal anesthesia for cesarean section (relative risk of 0.61, 95% CI 0.47–0.78) [15].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Maternal Lower Limb Compression on Amniotic Fluid Index, Uteroplacental Perfusion, and Fetal Blood Flow in Isolated Oligohydramnios

Sgayer,

Frank Wolf,

Mustafa Mikhail

et al. 2023

Fetal Diagn Ther

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Introduction: The aim of this study was to examine the efficacy of pneumatic compression of the maternal lower extremities in increasing the amniotic fluid index (AFI) in pregnancies complicated by isolated oligohydramnios. Methods: Women with isolated oligohydramnios (AFI <5 cm) at 32–41 weeks of pregnancy were connected to a sequential compression device for 60 min. Prior and after the application, AFI and the pulsatility index (PI) of a number of arteries were measured. Results: The median (interquartile range) maternal age of the 21 women included was 29 years (26.50–32.00), the median parity was 1 (1–2), and the median gestational age at intervention was 37.60 weeks (37.00–39.40). The median AFI increased after the application from 4.00 (3.62–4.50) to 6.08 cm (4.90–7.03) (p < 0.001). The median PI of the fetal renal artery decreased from 2.30 (2.01–2.88) to 2.26 (1.68–2.71) (p = 0.01). The hourly fetal urine production did not increase. Changes were not significant in the PI of the umbilical artery, the middle cerebral artery, and the bilateral uterine arteries. Conclusion: Short-term activation of pneumatic compression on maternal lower extremities could increase the AFI in women with isolated oligohydramnios.

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Lower limbs venous compression reduces the incidence of maternal hypotension following epidural analgesia during term labor

Cited by 4 publications

References 20 publications

Global guidelines trends and controversies in lower limb venous and lymphatic disease

Global guidelines trends and controversies in lower limb venous and lymphatic disease

Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

The Effect of Maternal Lower Limb Compression on Amniotic Fluid Index, Uteroplacental Perfusion, and Fetal Blood Flow in Isolated Oligohydramnios

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