心血管疾病与诊断

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

Abstract

Manasij Mitra, Dipanwita Basu, Tanmoy Ganguly, Sandeep Kumar Kar, Sujit Chaterjee

Introduction: Anesthesia for cesarean section in a patient with preeclampsia is far more complicated than an otherwise normal pregnancy for several reasons. Apart from the risks of high incidence of intrauterine growth restriction, fetal distress and prematurity, there are risk of increased perioperative morbidity due to altered hemodynamics

Material and methods: This study was conducted on 100 booked pregnant woman of ASA physical status I and II (Normotensive) or III (Preeclamptic), between 19 to 30 years of age, carrying a live, mature, healthy, single fetus posted for elective cesarean section. Patients were counseled during preoperative examination and 50 normotensive and 50 preeclamptic patients were recruited for this study after obtaining informed consent from each of the patient in their own language.

Result and Analyses: In this study, the authors found significant differences in SBP, DBP and MAP at different point of times in both the groups. One probable explanation of this may be the use of invasive arterial blood pressure monitoring in place of non-invasive monitoring unlike other studies. Also the preoperative blood pressure values were significantly different in both the groups. More phenylephrine consumption was noted in the normotensive group.

Conclusion: subarachnoid block in preeclampsia patients associated with better perioperative hemodynamic stability, less hypotension, less vasopressor consumption and more gradual blood pressure changes.