Effect of crystalloid and colloid preloading on uteroplacental and maternal haemodynamic state during spinal anaesthesia for Caesarean section

J. Karinen, Juha Rasanen, S. Alahuhta, R. Jouppila, P. Jouppila

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

We have studied the effects of crystalloid 1 litre (lactated Ringer's) or colloid 0.5 litre (hydroxyethyl starch) preloading in 26 healthy parturients undergoing elective Caesarean section under spinal anaesthesia. Maternal placental uterine artery circulation was measured using a pulsed colour Doppler technique with simultaneous measurement of maternal haemodynamics. A high incidence of maternal hypotension was observed during spinal anaesthesia in the crystalloid group (62%) but the incidence was lower in the colloid group (38%). Central venous pressure was increased significantly in both groups after preload but decreased shortly after induction of spinal anaesthesia to baseline values. The mean pulsatility index (PI) in the uterine arteries did not change during preload or spinal block. A surprising finding was the widespread variation and some high values for the uterine artery PI after spinal anaesthesia. These individual increases in PI were transient and always returned to baseline values within 2 min. These results suggest that preloading with either solution is ineffective in preventing maternal hypotension and that changes in maternal heart rate, systolic arterial pressure and central venous pressure during spinal anaesthesia were not associated with rapid individual increases in uteroplacental vascular resistance. These changes seemed not to have any major effect, however, on the clinical condition of the newborn, as assessed by Apgar scores and umbilical artery pH values.

Original languageEnglish (US)
Pages (from-to)531-535
Number of pages5
JournalBritish Journal of Anaesthesia
Volume75
Issue number5
StatePublished - 1995
Externally publishedYes

Fingerprint

Spinal Anesthesia
Colloids
Cesarean Section
Uterine Artery
Hemodynamics
Mothers
Central Venous Pressure
Hypotension
Umbilical Arteries
Apgar Score
Incidence
Vascular Resistance
Starch
Arterial Pressure
Color
Heart Rate
crystalloid solutions
Parturition
Blood Pressure

Keywords

  • Anaesthesia, obstetric
  • Anaesthetic techniques, subarachnoid
  • Blood, flow, feto-uteroplacental

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Effect of crystalloid and colloid preloading on uteroplacental and maternal haemodynamic state during spinal anaesthesia for Caesarean section. / Karinen, J.; Rasanen, Juha; Alahuhta, S.; Jouppila, R.; Jouppila, P.

In: British Journal of Anaesthesia, Vol. 75, No. 5, 1995, p. 531-535.

Research output: Contribution to journalArticle

Karinen, J. ; Rasanen, Juha ; Alahuhta, S. ; Jouppila, R. ; Jouppila, P. / Effect of crystalloid and colloid preloading on uteroplacental and maternal haemodynamic state during spinal anaesthesia for Caesarean section. In: British Journal of Anaesthesia. 1995 ; Vol. 75, No. 5. pp. 531-535.
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