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Spinal block caesarean section in parturients with pregnancy-induced hypertension.
East Afr Med J. 1998 Apr; 75(4):227-31.EA

Abstract

The objective of this work was to determine whether parturients with pregnancy-induced hypertension (PIH) are at higher risk of post-spinal hypotension at caesarean section. This was an observational study of 24 women with PIH undergoing caesarean section under spinal analgesia with 0.5% hyperbaric bupivacaine, compared with 24 matched normotensive parturients receiving a spinal block for caesarean section. The mean intra-operative systolic arterial pressure (SAP) was similar with and without PIH (p = 0.38). The mean percentage decrease in SAP of baseline was more with PIH (16.2%) than in the controls (0.5%) (p < 0.001). The number of episodes of severe hypotension (SAP decrease to < or = 80% of baseline and < 90 mmHg) (p = 0.80) as well as the magnitude (p = 0.31) of severe hypotension was similar in both groups. There was no difference in the evolution of diastolic arterial pressure and maternal pulse rate between cases and controls. Maximum levels of upper sensory blockade were similar. Foetal and maternal outcome was similar with and without PIH. The decrease in SAP is less on an absolute scale but more on a percentile basis with PIH at caesarean section under spinal analgesia than in normotensive patients. The difference, however, is not clinically sufficient to discourage spinal analgesia for caesarean section with a low dose (1.5 ml, 7.5 mg) of 0.5% hyperbaric bupivacaine in parturients with PIH.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Transkei, E. Cape, South Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9745840

Citation

Van Bogaert, L J.. "Spinal Block Caesarean Section in Parturients With Pregnancy-induced Hypertension." East African Medical Journal, vol. 75, no. 4, 1998, pp. 227-31.
Van Bogaert LJ. Spinal block caesarean section in parturients with pregnancy-induced hypertension. East Afr Med J. 1998;75(4):227-31.
Van Bogaert, L. J. (1998). Spinal block caesarean section in parturients with pregnancy-induced hypertension. East African Medical Journal, 75(4), 227-31.
Van Bogaert LJ. Spinal Block Caesarean Section in Parturients With Pregnancy-induced Hypertension. East Afr Med J. 1998;75(4):227-31. PubMed PMID: 9745840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal block caesarean section in parturients with pregnancy-induced hypertension. A1 - Van Bogaert,L J, PY - 1998/9/24/pubmed PY - 1998/9/24/medline PY - 1998/9/24/entrez SP - 227 EP - 31 JF - East African medical journal JO - East Afr Med J VL - 75 IS - 4 N2 - The objective of this work was to determine whether parturients with pregnancy-induced hypertension (PIH) are at higher risk of post-spinal hypotension at caesarean section. This was an observational study of 24 women with PIH undergoing caesarean section under spinal analgesia with 0.5% hyperbaric bupivacaine, compared with 24 matched normotensive parturients receiving a spinal block for caesarean section. The mean intra-operative systolic arterial pressure (SAP) was similar with and without PIH (p = 0.38). The mean percentage decrease in SAP of baseline was more with PIH (16.2%) than in the controls (0.5%) (p < 0.001). The number of episodes of severe hypotension (SAP decrease to < or = 80% of baseline and < 90 mmHg) (p = 0.80) as well as the magnitude (p = 0.31) of severe hypotension was similar in both groups. There was no difference in the evolution of diastolic arterial pressure and maternal pulse rate between cases and controls. Maximum levels of upper sensory blockade were similar. Foetal and maternal outcome was similar with and without PIH. The decrease in SAP is less on an absolute scale but more on a percentile basis with PIH at caesarean section under spinal analgesia than in normotensive patients. The difference, however, is not clinically sufficient to discourage spinal analgesia for caesarean section with a low dose (1.5 ml, 7.5 mg) of 0.5% hyperbaric bupivacaine in parturients with PIH. SN - 0012-835X UR - https://www.unboundmedicine.com/medline/citation/9745840/Spinal_block_caesarean_section_in_parturients_with_pregnancy_induced_hypertension_ L2 - http://www.diseaseinfosearch.org/result/5922 DB - PRIME DP - Unbound Medicine ER -