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Manual displacement of the uterus during Caesarean section.
Anaesthesia. 2007 May; 62(5):460-5.A

Abstract

Ninety ASA 1 and 2 pregnant women with term singleton pregnancies and no maternal and fetal complications, scheduled for elective or emergency Caesarean section, were randomly allocated to group LT (15 degrees left lateral table tilt, n = 45) and group MD (leftward manual displacement, n = 45). Subarachnoid block was established with a 25-gauge spinal needle at the L3-L4 interspace using 1.5 ml of 0.5% hyperbaric bupivacaine. A median sensory level of T6 was observed in both groups but the incidence of hypotension was markedly lower in group MD when compared to group LT (4.4% vs 40%; p < 0.001) with a significant reduction in mean (SD) ephedrine requirement (6 (0) vs 11.3 (4.9) mg; p < 0.001). The mean (SD) fall in systolic blood pressure was 28.8 (7.3) mmHg in group LT and 20 (12.7) mmHg in group MD. The time to maximum fall in systolic blood pressure was similar in both groups (4.5 min). We conclude that manual displacement of the uterus effectively reduces the incidence of hypotension and ephedrine requirements when compared to 15 degrees left lateral table tilt in parturients undergoing Caesarean section.

Authors+Show Affiliations

Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India. p_kundra@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17448057

Citation

Kundra, P, et al. "Manual Displacement of the Uterus During Caesarean Section." Anaesthesia, vol. 62, no. 5, 2007, pp. 460-5.
Kundra P, Khanna S, Habeebullah S, et al. Manual displacement of the uterus during Caesarean section. Anaesthesia. 2007;62(5):460-5.
Kundra, P., Khanna, S., Habeebullah, S., & Ravishankar, M. (2007). Manual displacement of the uterus during Caesarean section. Anaesthesia, 62(5), 460-5.
Kundra P, et al. Manual Displacement of the Uterus During Caesarean Section. Anaesthesia. 2007;62(5):460-5. PubMed PMID: 17448057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Manual displacement of the uterus during Caesarean section. AU - Kundra,P, AU - Khanna,S, AU - Habeebullah,S, AU - Ravishankar,M, PY - 2007/4/24/pubmed PY - 2007/6/8/medline PY - 2007/4/24/entrez SP - 460 EP - 5 JF - Anaesthesia JO - Anaesthesia VL - 62 IS - 5 N2 - Ninety ASA 1 and 2 pregnant women with term singleton pregnancies and no maternal and fetal complications, scheduled for elective or emergency Caesarean section, were randomly allocated to group LT (15 degrees left lateral table tilt, n = 45) and group MD (leftward manual displacement, n = 45). Subarachnoid block was established with a 25-gauge spinal needle at the L3-L4 interspace using 1.5 ml of 0.5% hyperbaric bupivacaine. A median sensory level of T6 was observed in both groups but the incidence of hypotension was markedly lower in group MD when compared to group LT (4.4% vs 40%; p < 0.001) with a significant reduction in mean (SD) ephedrine requirement (6 (0) vs 11.3 (4.9) mg; p < 0.001). The mean (SD) fall in systolic blood pressure was 28.8 (7.3) mmHg in group LT and 20 (12.7) mmHg in group MD. The time to maximum fall in systolic blood pressure was similar in both groups (4.5 min). We conclude that manual displacement of the uterus effectively reduces the incidence of hypotension and ephedrine requirements when compared to 15 degrees left lateral table tilt in parturients undergoing Caesarean section. SN - 0003-2409 UR - https://www.unboundmedicine.com/medline/citation/17448057/Manual_displacement_of_the_uterus_during_Caesarean_section_ DB - PRIME DP - Unbound Medicine ER -