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Fluid therapy in caesarean

D Vinayagam, S Bampoe, B Thilaganathan, A Khalil
BACKGROUND: Intraoperative haemodynamic monitoring is carried out in high-risk surgical patients, often using invasive methods, including pulmonary artery catheterisation. Early goal-directed therapy in high-risk surgical patients reduces tissue hypoxia, organ failure and improves outcomes. Significant maternal morbidity arises as a result of perioperative haemorrhage. At present, heart rate and brachial blood pressure are used as proxy markers to aid in fluid resuscitation, however, we know that these exhibit minimal change during early stages of shock, and are poor indicators of the adequacy of therapeutic intervention...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Nicolas Brogly, Renato Schiraldi, Laura Puertas, Genaro Maggi, Eduardo Alonso Yanci, Ever Hugo Martinez Maldonado, Emilia Guasch Arévalo, Fernando Gilsanz Rodríguez
BACKGROUND: The delivery of cardiac patients is a challenge for the anaesthesiologist, to whom the welfare of both the mother and the foetus is a main issue. In case of caesarean section, advanced monitoring allows to optimize haemodynamic condition and to improve morbidity and mortality. OBJECTIVE: To describe the use of pulse contour analysis calibrated by Trans-pulmonar thermodilution (Picco Plus(®)) for the perioperative management of a caesarean section in a patient with severe cardiomyopathy...
May 2016: Brazilian Journal of Anesthesiology
Eldrid Langesæter, Matthew Gibbs, Robert A Dyer
PURPOSE OF REVIEW: Haemodynamic monitoring in obstetric patients has evolved during the last decade, with the development of minimally invasive and noninvasive continuous cardiac output (CO) monitors. This review focuses on recent articles that improve our understanding of physiology and haemodynamic changes during spinal anaesthesia in healthy pregnant women, and pathophysiology in women with preeclampsia and other cardiovascular disease. RECENT FINDINGS: Recent research findings in healthy women focus on the haemodynamic changes due to aortocaval compression, fluid administration, vasopressor therapy, and oxytocin during spinal anaesthesia for caesarean delivery...
June 2015: Current Opinion in Anaesthesiology
T Wang, l H Jiang, J B Zhu, X Y Wei, L Li, B Liu
OBJECTIVE: Preeclampsia is a unique disease of pregnancy. Delivery via caesarean section is the most important way of terminating the pregnancy and treating preeclampsia. Perioperative fluid therapy is performed to maintain the circulatory volume and reduce tissue edema. This study evaluated the effects of hypertonic sodium chloride hydroxyethyl starch 40 (HSH40) as perioperative fluid therapy for preeclampsia patients. MATERIALS AND METHODS: Forty preeclamptic women were randomly divided into two groups: the Ringer's solution group and the HSH40 group...
2015: Clinical and Experimental Obstetrics & Gynecology
Neele Schepker, Guillermo-José Garcia-Rocha, Frauke von Versen-Höynck, Peter Hillemanns, Cordula Schippert
PURPOSE: Caesarean delivery (c-section) scar dehiscences may cause bleeding abnormalities, e.g. postmenstrual spotting, dysmenorrhea and abdominal pain, secondary sterility and at worst peripartum uterine rupture. The purpose of this study was firstly to identify the correlation of women's complaints after c-section with scar-related clinical symptoms. Secondly, the effects of corrective surgery on preoperatively existing complaints were analysed and assessed in the patient population of our clinic...
June 2015: Archives of Gynecology and Obstetrics
Nicolas Brogly, Renato Schiraldi, Laura Puertas, Genaro Maggi, Eduardo Alonso Yanci, Ever Hugo Martinez Maldonado, Emilia Guasch Arévalo, Fernando Gilsanz Rodríguez
BACKGROUND: The delivery of cardiac patients is a challenge for the anaesthesiologist, to whom the welfare of both the mother and the foetus is a main issue. In case of caesarean section, advanced monitoring allows to optimize haemodynamic condition and to improve morbidity and mortality. OBJECTIVE: To describe the use of pulse contour analysis calibrated by Trans-pulmonar thermodilution (Picco Plus(®)) for the perioperative management of a caesarean section in a patient with severe cardiomyopathy...
May 2016: Revista Brasileira de Anestesiologia
Tülay Özkan Seyhan, Olgaç Bezen, Mukadder Orhan Sungur, Ibrahim Kalelioğlu, Meltem Karadeniz, Kemalettin Koltka
BACKGROUND: Magnesium has anti-nociceptive effects and potentiates opioid analgesia following its systemic and neuraxial administration. However, there is no study evaluating the effects of intravenous (IV) magnesium sulphate (MgSO4) therapy on spinal anaesthesia characteristics in severely pre-eclamptic patients. AIMS: The aim of this study was to compare spinal anaesthesia characteristics in severely pre-eclamptic parturients treated with MgSO4 and healthy preterm parturients undergoing caesarean section...
June 2014: Balkan Medical Journal
Yasmeen Khooharo, Jabeen Zubair Yousfani, Sara Haider Malik, Aneela Amber, Numan Majeed, Nimra Haider Malik, Hira Pervez, Isra Majeed, Naeem Majeed
BACKGROUND: Obstructed labour with ruptured uterus is a serious obstetrical complication with a high incidence of maternal and foetal morbidity and mortality. This study was conducted to find out the incidence of uterine rupture particularly in the patients of obstructed labour (OL), foeto-maternal outcome of such patients, and its management. METHODS: This two year descriptive study was conducted in the Department of Obstetrics and Gynaecology Unit-I, at Muhammad Medical College Hospital from 1st January 2007 to 31st December 2008, on 40 diagnosed cases of OL...
January 2013: Journal of Ayub Medical College, Abbottabad: JAMC
R Schiraldi, L Calderón, G Maggi, N Brogly, E Guasch, F Gilsanz
Massive postpartum haemorrhage is a major worldwide cause of maternal mortality. Management requires intensive fluid resuscitation and blood transfusion. Although fluid therapy is often directed by the results of a full blood count and clotting screen, recent technological advances allow monitoring of haemodynamic function and cardiac output. Transoesophageal Doppler technology has been used during haemorrhagic shock in non-obstetric patients. We present the case of a caesarean delivery complicated by massive haemorrhage where transoesophageal Doppler monitoring with the CardioQ-ODM™ was used to guide fluid therapy and the use of vasoactive drugs...
February 2014: International Journal of Obstetric Anesthesia
Costantino Di Carlo, Fabiana Savoia, Virginia Gargano, Stefania Sparice, Giuseppe Bifulco, Carmine Nappi
We here report two cases of spontaneous, familial, recurrent ovarian hyperstimulation syndrome ended in a successful pregnancy. First case was a 26-year-old woman, gravida 3 para 0 and two previous terminations of pregnancy due to spontaneous ovarian hyperstimulation syndrome (OHSS). During her pregnancy, patient was treated with IV fluid therapy, albumin and thromboembolic prophylaxis and required pleural and peritoneal drainage. She was referred to the hospital twice, at 8 and 28 weeks'. At 32 weeks due to worsening of clinical condition, decision was made for a caesarean section...
October 2013: Gynecological Endocrinology
Feroza Dawood, Therese Dowswell, Siobhan Quenby
BACKGROUND: Several factors may influence the progression of normal labour. It has been postulated that the routine administration of intravenous fluids to keep women adequately hydrated during labour may reduce the period of contraction and relaxation of the uterine muscle, and may ultimately reduce the duration of the labour. It has also been suggested that intravenous fluids may reduce caesarean sections (CS) for prolonged labour. However, the routine administration of intravenous fluids to labouring women has not been adequately elucidated although it is a widely-adopted policy, and there is no consensus on the type or volume of fluids that are required, or indeed, whether intravenous fluids are at all necessary...
2013: Cochrane Database of Systematic Reviews
Manal Kassab, Wadah M Khriesat, Hiba Bawadi, Jasim Anabrees
BACKGROUND: Transient tachypnoea of the newborn (TTN) results from delayed clearance of lung liquid and is a common cause of admission of full term infants to neonatal intensive care units. The condition is particularly common after elective caesarean section. Conventional treatment involves appropriate oxygen administration and continuous positive airway pressure in some cases. Most infants receive antibiotic therapy. Hastening the clearance of lung liquid may shorten the duration of the symptoms and reduce complications...
2013: Cochrane Database of Systematic Reviews
Andrzej Marciniak, Maria Wujtewicz, Radosław Owczuk
BACKGROUND: Fluid therapy is the most commonly used treatment to prevent hypotension associated with spinal anaesthesia. The aim of this study was to test the hypothesis that a balanced solution of 6% hydroxyethyl starch will have a more beneficial impact on the condition of newborns at birth than an unbalanced 6% solution of HES. METHODS: The study participants included 51 healthy parturients undergoing elective caesarean section with spinal anaesthesia. Patients received a transfusion of 500 mL of unbalanced 6% HES (Voluven) or balanced 6% HES (Tetraspan) prior to anaesthesia...
January 2013: Anaesthesiology Intensive Therapy
Siba Prosad Paul, Bryony Alexis Smith, Karun Kumar Luthra
Pregnant women in labour are generally encouraged by their carers to continue taking plenty of oral fluids. This is sometimes supplemented by intravenous fluids either due to a clinical necessity or in preparation for a caesarean section. It is important that there is clear documentation of the amount of fluids received by pregnant women in the perinatal period as excessive maternal fluid has been associated with low serum sodium in neonates. This often goes under-recognised; therefore it is important to consider this in a neonate presenting with hyponatraemia in the first day of life...
February 2013: Practising Midwife
N F Collins, M Bloor, N J McDonnell
Rotational thromboelastometry is a viscoelastomeric, point-of-care method for testing haemostasis in whole blood which can be visualised rapidly, in real time, in the operating theatre. Advantages over traditional coagulation tests relate to the rapid feedback of results and the ability to visualise hyperfibrinolysis. We present a case of suspected amniotic fluid embolism that presented with sudden respiratory arrest associated with haemodynamic compromise during a non-elective caesarean delivery. Soon after the collapse, coagulopathy developed...
January 2013: International Journal of Obstetric Anesthesia
F J Mercier, M Augè, C Hoffmann, C Fischer, A Le Gouez
The aim of the study was to review maternal hypotension during caesarean delivery with spinal anesthesia. Obstetric complications, such as obstetric hemorrhage and problems related to concomitant maternal diseases are not considered. Reports of hypotension during spinal anesthesia for elective caesarean delivery are frequent (70-80%) when pharmacological prophylaxis is not used. Although some physical methods (leg wrapping, thromboembolic stockings) and the prevention of aorto-caval compression (left lateral tilt of the uterus) are useful, main prevention relies on two pharmacological methods, vasopressor therapy and intravascular fluid loading generally in combination...
January 2013: Minerva Anestesiologica
M D Akter, N Kabir, M S Shah, F Islam, S Tasnim
This was a randomized controlled trial on 64 pregnant women from 32 to 35 weeks gestation, in one year period to determine the effect of maternal hydration by oral water in oligohydramnios amniotic fluid index (AFI) ≤ 5. Studied women were randomly divided into two groups. Group A (intervention group) women were instructed to drink 2 liters of water within 2 hours and from the next day extra 2 liters of water daily for 7 days. Group B (control group) women were allowed for routine water intake. AFI was done after 2 hours, 24 hours and 7 days of oral hydration therapy in both the groups...
October 2012: Mymensingh Medical Journal: MMJ
Krzysztof Zajac, Małgorzata Zajac, Waldemar Hładki, Robert Jach
PURPOSE OF THE STUDY: To assess the effectiveness of postoperatively applied pharmacological prophylaxis and the impact of demographic parameters (age, height, weight), gestational age, parturients' morbidity (hypertension, motion sickness), postoperative fluid resuscitation, applied anaesthetic technique (spinal needle type and diameter, patient's positioning, choice of intervertebral space for puncturing dura, a dose of local anaesthetic) on the incidence of PDPH after spinal anaesthesia for Caesarean section...
2012: Przegla̧d Lekarski
Carlos António, Nelson Marçal, Carlos Lopes, Francisco Tortosa, Pilar Acevedo, Jorge Monteiro, Filipe Monteiro, Llurdes Correia, Ganriela Brum, A Bugalho De Almeida
Amniotic fluid embolism (AFE) is a rare pathological syndrome, sometimes fatal that arises as an obstetric complication during vaginal delivery, caesarean, immediate postpartum or during pregnancy. It remains as an important cause of fetal and maternal morbidity and mortality. The authors present a clinical report of a young woman who developed an acute respiratory failure during labour demanding invasive mechanical ventilation and an urgent caesarean. In spite of early medical intensive therapy, hypoxemia was refractory and had a progressive worsening leading to multi-organ failure and ultimately to death...
November 2011: Acta Médica Portuguesa
Clara Vaz Marecos, Marta Ferreira, Maria Manuela Ferreira, Maria Rosalina Barroso
After a 36-week diamniotic dichorionic gestation, an infant was delivered by elective caesarean section due to growth restriction and altered diastolic flow in the umbilical artery. Birth weight was 2140 g. The patient was admitted for exclusive parenteral nutrition, with umbilical venous catheter placement. Sinus tachycardia and temperature instability with positive inflammatory markers occurred at 51 h. Penicillin and gentamicin were started, but 6 h later septic shock with disseminated intravascular coagulation was noted...
2012: BMJ Case Reports
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