Foundations in Obstetric Anesthesia

Chestnut, D.H.; Polley, Linda S.; Tsen, Lawrence C.; Wong, Cynthia A.

doi:10.1016/b978-0-323-05541-3.00073-9

Cited by 51 publications

(119 citation statements)

References 2 publications

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“…This plasma volume expansion is followed by an increase in erythrocyte mass, which starts at 8 weeks of pregnancy and continues in the second and third trimesters. Plasma expansion exceeds erythrocyte mass, and the resulting haemodilution is believed to be a physiological adaptation to pregnancy, allowing delivery of nutrients to the foetus, protection of the mother from hypotension, and a reduction of the risks associated with haemorrhage at delivery (Gaiser, 2014). …”

Section: Antenatal Iron Requirements In Low‐income Countriesmentioning

confidence: 99%

Safety and benefits of antenatal oral iron supplementation in low‐income countries: a review

2017

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SummaryThe World Health Organization recommends universal iron supplementation of 30–60 mg/day in pregnancy but coverage is low in most countries. Its efficacy is uncertain, however, and there has been a vigorous debate in the last decade about its safety, particularly in areas with a high burden of malaria and other infectious diseases. We reviewed the evidence on the safety and efficacy of antenatal iron supplementation in low‐income countries. We found no evidence that daily supplementation at a dose of 60 mg leads to increased maternal Plasmodium infection risk. On the other hand, recent meta‐analyses found that antenatal iron supplementation provides benefits for maternal health (severe anaemia at postpartum, blood transfusion). For neonates, there was a reduced prematurity risk, and only a small or no effect on birth weight. A recent trial showed, however, that benefits of antenatal iron supplementation on maternal and neonatal health vary by maternal iron status, with substantial benefits in iron‐deficient women. The benefits of universal iron supplementation are likely to vary with the prevalence of iron deficiency. As a consequence, the balance between benefits and risks is probably more favourable in low‐income countries than in high‐income countries despite the higher exposure to infectious pathogens.

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Section: Antenatal Iron Requirements In Low‐income Countriesmentioning

confidence: 99%

Safety and benefits of antenatal oral iron supplementation in low‐income countries: a review

2017

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“…Hypotension, due to sympathetic block, is the most common side effect of spinal anesthesia in cesarean section and can lead to severe injuries ( 2 - 4 ). Even with preventive approaches, its prevalence is 80% - 100% in parturients undergoing cesarean section ( 5 - 7 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of Glucose Containing Crystalloid Infusion on Maternal Hemodynamic Status After Spinal Anesthesia for Cesarean Section

et al. 2018

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BackgroundDespite preventive strategies, hypotension is the most common complication of spinal anesthesia in cesarean section.ObjectivesThe aim of this study was to assess the effect of glucose-containing crystalloid infusion on maternal hemodynamic status after spinal anesthesia for cesarean section.MethodsIn this prospective, randomized, double-blind clinical trial, 80 parturients undergoing elective cesarean section with spinal anesthesia were studied. In group A (n = 40) ringer with 1% glucose solution (10 gr glucose in 1000 mL ringer) and in group B (n = 40) only ringer solution infused before and after spinal anesthesia. Demographic data, hemodynamic change, complications and their treatments, maternal blood sugar level and neonatal APGAR (appearance, pulse, grimace, activity and respiration) score, intraoperative fluid, duration of surgery, and anesthesia were recorded in the two groups.ResultsThe incidence of hypotension in group A was significantly lower than group B (27.5% vs 75%) (P = 0.002). Other complications (sustained hypotension, nausea, pallor, and shivering were significantly lower in parturients of the group A (P < 0.05). Maternal blood sugar (BS), before and after surgery, was not significantly different in the two groups (P = 0.207 and P = 0.239, respectively). There was no statistically significant difference in the APGAR score of neonates at the 1st and 5th minutes of the birth between the two groups (P = 0.076).ConclusionsIt seems that adding 1% glucose to crystalloid solution improves the hemodynamic status and decreases post-spinal anesthesia complications without significant changes in the maternal blood sugar level and APGAR score of neonates.

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“…Hyperlordosis can change the relationship between surface anatomy of vertebrae and vertebral columns. During pregnancy, due to these changes, the intervertebral spaces are narrow and can make the median approach for spinal puncture more difficult ( 1 - 3 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Pendant Position and Traditional Sitting Position for Successful Spinal Puncture in Spinal Anesthesia for Cesarean Section

2017

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BackgroundSuccess of spinal anesthesia in pregnant females is strongly influenced by the position of the patient at the time of spinal insertion. Pendant position is a new position introduced to increase the intervertebral spaces. The current study aimed at comparing successful spinal puncture among the patients with pendant position in comparison with the ones with traditional sitting position for the elective caesarean section.MethodsThe current study was a non-blinded, randomized controlled trial (RCT) (registration code: NCT02753660 (ClinicalTrial.gov) on pregnant females undergoing spinal anesthesia. The participants were divided into 2 groups by the random consecutive sampling method; group A (pendant position) and group B (traditional sitting position). The successful placement of spinal needle was determined by the number of attempts, the amount of bone contact, and the time of spinal puncture. The inclusion criteria were pregnant females aged 18 to 45 years, body mass index (BMI) of 18 to 35 kg/m2, and the physical status I to III, based on American society of anesthesiologists classification (ASA).ResultsFollowing the approval of the ethical committee, 308 subjects were enrolled in the study. The rate of successful puncture on the 1st attempt of group A was significantly high (92% vs. 78%, P value = 0.001). Additionally, group A had significantly less total amount of bone contact (185 vs. 421, P value < 0.001) and shorter time for spinal puncture (9 seconds vs. 12 seconds, P value < 0.001).ConclusionsPendant position was significantly better than traditional sitting position to provide successful 1st attempt spinal puncture in pregnant females undergoing cesarean section.

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Foundations in Obstetric Anesthesia

Cited by 51 publications

References 2 publications

Safety and benefits of antenatal oral iron supplementation in low‐income countries: a review

Safety and benefits of antenatal oral iron supplementation in low‐income countries: a review

Effect of Glucose Containing Crystalloid Infusion on Maternal Hemodynamic Status After Spinal Anesthesia for Cesarean Section

Comparison Between Pendant Position and Traditional Sitting Position for Successful Spinal Puncture in Spinal Anesthesia for Cesarean Section

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