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Fetal effects of prophylactic ephedrine and maternal hypotension during regional anesthesia for cesarean section.
J Matern Fetal Med 1996 Mar-Apr; 5(2):79-84JM

Abstract

The purpose of this study was to evaluate the effects of a prophylactic intravenous bolus of ephedrine on the incidence and severity of maternal hypotension and on neonatal outcome. Term healthy parturients (n = 122) scheduled for elective repeat cesarean section under regional anesthesia were studied. Ninety-two women received 10 mg ephedrine as a prophylactic intravenous bolus prior to intrathecal epidural local anesthesia. Thirty parturients who served as controls did not receive prophylactic ephedrine. Maternal blood pressures, Apgar scores, and umbilical cord blood acid-base status were evaluated. Sixty-three of 92 women (69%) who received intravenous prophylactic ephedrine prior to regional anesthesia developed hypotension compared to 21 (70%) controls. The mean (+/- SD) lowest systolic blood pressure was similar in both groups (95.6 +/- 12.9 vs. 96 +/- 8.9 mmHg; P = 0.86). The mean (+/-SD) fetal pH was significantly lower with prophylactic ephedrine than controls (7.24 +/- 0.07 vs. 7.28 +/- 0.05; P = 0.001). The frequency of umbilical artery blood pH < 7.20 was 10.6% for the ephedrine group vs. 3.2% for controls (P = 0.024). Among newborns of hypotensive mothers, the frequency of umbilical artery blood pH < 7.20 was 30.2% and 4.6% for the ephedrine and control groups, respectively (P = 0.018). Intravenous prophylaxis with ephedrine did not significantly decrease the frequency of hypotension in women receiving regional anesthesia and resulted in a greater proportion of umbilical artery blood pH values < 7.20.

Authors+Show Affiliations

Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas 75235-9032, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

8796773

Citation

Shearer, V E., et al. "Fetal Effects of Prophylactic Ephedrine and Maternal Hypotension During Regional Anesthesia for Cesarean Section." The Journal of Maternal-fetal Medicine, vol. 5, no. 2, 1996, pp. 79-84.
Shearer VE, Ramin SM, Wallace DH, et al. Fetal effects of prophylactic ephedrine and maternal hypotension during regional anesthesia for cesarean section. J Matern Fetal Med. 1996;5(2):79-84.
Shearer, V. E., Ramin, S. M., Wallace, D. H., Dax, J. S., & Gilstrap, L. C. (1996). Fetal effects of prophylactic ephedrine and maternal hypotension during regional anesthesia for cesarean section. The Journal of Maternal-fetal Medicine, 5(2), pp. 79-84.
Shearer VE, et al. Fetal Effects of Prophylactic Ephedrine and Maternal Hypotension During Regional Anesthesia for Cesarean Section. J Matern Fetal Med. 1996;5(2):79-84. PubMed PMID: 8796773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fetal effects of prophylactic ephedrine and maternal hypotension during regional anesthesia for cesarean section. AU - Shearer,V E, AU - Ramin,S M, AU - Wallace,D H, AU - Dax,J S, AU - Gilstrap,L C,3rd PY - 1996/3/1/pubmed PY - 2001/3/28/medline PY - 1996/3/1/entrez SP - 79 EP - 84 JF - The Journal of maternal-fetal medicine JO - J Matern Fetal Med VL - 5 IS - 2 N2 - The purpose of this study was to evaluate the effects of a prophylactic intravenous bolus of ephedrine on the incidence and severity of maternal hypotension and on neonatal outcome. Term healthy parturients (n = 122) scheduled for elective repeat cesarean section under regional anesthesia were studied. Ninety-two women received 10 mg ephedrine as a prophylactic intravenous bolus prior to intrathecal epidural local anesthesia. Thirty parturients who served as controls did not receive prophylactic ephedrine. Maternal blood pressures, Apgar scores, and umbilical cord blood acid-base status were evaluated. Sixty-three of 92 women (69%) who received intravenous prophylactic ephedrine prior to regional anesthesia developed hypotension compared to 21 (70%) controls. The mean (+/- SD) lowest systolic blood pressure was similar in both groups (95.6 +/- 12.9 vs. 96 +/- 8.9 mmHg; P = 0.86). The mean (+/-SD) fetal pH was significantly lower with prophylactic ephedrine than controls (7.24 +/- 0.07 vs. 7.28 +/- 0.05; P = 0.001). The frequency of umbilical artery blood pH < 7.20 was 10.6% for the ephedrine group vs. 3.2% for controls (P = 0.024). Among newborns of hypotensive mothers, the frequency of umbilical artery blood pH < 7.20 was 30.2% and 4.6% for the ephedrine and control groups, respectively (P = 0.018). Intravenous prophylaxis with ephedrine did not significantly decrease the frequency of hypotension in women receiving regional anesthesia and resulted in a greater proportion of umbilical artery blood pH values < 7.20. SN - 1057-0802 UR - https://www.unboundmedicine.com/medline/citation/8796773/Fetal_effects_of_prophylactic_ephedrine_and_maternal_hypotension_during_regional_anesthesia_for_cesarean_section_ L2 - https://medlineplus.gov/cesareansection.html DB - PRIME DP - Unbound Medicine ER -