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Efficacy of fixed-dose phenylephrine bolus for treating post-spinal hypotension: Comparison between pre-eclamptics and normotensives.
J Anaesthesiol Clin Pharmacol
August 2022
Department of Obstetrics and Gynecology, UCMS and GTB Hospital, Delhi, India.
Background And Aims: Pre-eclamptic parturients may have an exaggerated response to vasopressors. This study compares the efficacy of a 50 μg fixed bolus of phenylephrine for treatment of post-spinal hypotension in pre-eclamptic versus normotensive parturients.
Material And Methods: After written informed consent and ethics committee approval, 30 normotensive and 30 pre-eclamptic parturients between 18 and 40 years with singleton term pregnancy about to undergo cesarean section (CS) under spinal anesthesia were included.
Calculation of effective dose of phenylephrine bolus for treatment of post-spinal hypotension in pre-eclamptic patients undergoing caesarean section - a non-randomised controlled trial.
Int J Obstet Anesth
November 2023
Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Background: Patients with pre-eclampsia require smaller vasopressor doses compared with those with normotension for management of post-spinal hypotension during caesarean section. However, the literature has little evidence as to the phenylephrine dose required for patients with pre-eclampsia.
Methods: Fifty patients, with either pre-eclampsia or normotension, and developing post-spinal hypotension during caesarean section under spinal anaesthesia, were studied.
Fetal heart rate tracings associated with eclamptic seizures.
Am J Obstet Gynecol
October 2022
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX.
Background: Although there is a well-known association between fetal bradycardia and maternal eclampsia, the characteristics of fetal heart rate tracings after an eclamptic seizure have not previously been thoroughly described. Fetal heart rate changes are thought to be related to maternal lactic acidemia caused by vasospasm and uterine hyperactivity leading to placental hypoperfusion and fetal hypoxia. The decision to intervene in the case of an abnormal fetal heart rate tracing after an eclamptic seizure is often difficult; however, maternal resuscitation should be the primary focus.
View Article and Find Full Text PDFA randomised double-blind comparison of phenylephrine and norepinephrine for the management of postspinal hypotension in pre-eclamptic patients undergoing caesarean section.
Eur J Anaesthesiol
October 2021
From the Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital (MM, LR, GTC), Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital (RA), Delhi Cancer Registry, Dr BRA IRCH, All India Institute of Medical Sciences, Delhi, India (RKM).
Background: Studies comparing phenylephrine and norepinephrine for the treatment of postspinal hypotension in pre-eclamptic patients are limited.
Objective: To compare bolus doses of phenylephrine and norepinephrine for treating hypotension in pre-eclamptic mothers undergoing caesarean section under spinal anaesthesia. It was hypothesised that norepinephrine and phenylephrine use would be associated with similar neonatal outcome.
Association of Maternal Hyperuricemia with Post-Spinal Hypotension in Pre-Eclamptic Parturients Undergoing Emergency Cesarean Delivery: a Prospective Observational Study.
Reprod Sci
February 2021
Department of Anesthesia and Intensive Care, Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Pre-eclampsia is commonly associated with higher serum uric acid levels, which is known to increase vascular tone. A previous retrospective study established a positive correlation between raised serum uric acid levels and reduced incidence of post-spinal hypotension. However, until date, this correlation has not been prospectively evaluated in exclusively pre-eclamptic women.
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