Ephedrine and phenylephrine for avoiding maternal hypotension due to spinal anaesthesia for caesarean section. Effects on uteroplacental and fetal haemodynamics

Seppo Alahuhta, Juha Rasanen, Pentti Jouppila, Riitta Jouppila, Arno I. Hollmén

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

The effects of i.v. vasopressors on Doppler velocimetry of the maternal uterine and placental arcuate arteries and the fetal umbilical, renal and middle cerebral arteries were studied during spinal anaesthesia in 19 healthy parturients undergoing elective caesarean section. Fetal myocardial function was investigated at the same time by M-mode echocardiography. The patients were randomized into two groups, to be given either ephedrine or phenylephrine as a prophylactic infusion supplemented with minor boluses if systolic arterial pressure decreased by more than 10 mmHg from the control value. Both the vasopressors restored maternal arterial pressure effectively. The ephedrine group showed no significant differences in any of the Doppler velocimetry recordings relative to the baseline values, but during the phenylephrine infusion the blood flow velocity waveform indices for the uterine and placental arcuate arteries increased significantly and vascular resistance decreased significantly in the fetal renal arteries. Healthy fetuses seem to tolerate these changes in uteroplacental circulation well, however, since the Apgar scores for the newborns and the acid-base values in the umbilical cord were within the normal range in both groups. The results suggest that some caution is required when selecting the specific vasopressor agent, the dosage and the mode of administration for the treatment of maternal hypotension secondary to spinal anaesthesia for caesarean section.

Original languageEnglish (US)
Pages (from-to)129-134
Number of pages6
JournalInternational Journal of Obstetric Anesthesia
Volume1
Issue number3
DOIs
StatePublished - 1992
Externally publishedYes

Fingerprint

Ephedrine
Spinal Anesthesia
Phenylephrine
Cesarean Section
Hypotension
Rheology
Hemodynamics
Mothers
Arterial Pressure
Placental Circulation
Umbilical Arteries
Apgar Score
Blood Flow Velocity
Umbilical Cord
Middle Cerebral Artery
Vasoconstrictor Agents
Renal Artery
Vascular Resistance
Echocardiography
Reference Values

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Psychology(all)

Cite this

Ephedrine and phenylephrine for avoiding maternal hypotension due to spinal anaesthesia for caesarean section. Effects on uteroplacental and fetal haemodynamics. / Alahuhta, Seppo; Rasanen, Juha; Jouppila, Pentti; Jouppila, Riitta; Hollmén, Arno I.

In: International Journal of Obstetric Anesthesia, Vol. 1, No. 3, 1992, p. 129-134.

Research output: Contribution to journalArticle

@article{131fa22bc5394985b3e2028339c6f42b,
title = "Ephedrine and phenylephrine for avoiding maternal hypotension due to spinal anaesthesia for caesarean section. Effects on uteroplacental and fetal haemodynamics",
abstract = "The effects of i.v. vasopressors on Doppler velocimetry of the maternal uterine and placental arcuate arteries and the fetal umbilical, renal and middle cerebral arteries were studied during spinal anaesthesia in 19 healthy parturients undergoing elective caesarean section. Fetal myocardial function was investigated at the same time by M-mode echocardiography. The patients were randomized into two groups, to be given either ephedrine or phenylephrine as a prophylactic infusion supplemented with minor boluses if systolic arterial pressure decreased by more than 10 mmHg from the control value. Both the vasopressors restored maternal arterial pressure effectively. The ephedrine group showed no significant differences in any of the Doppler velocimetry recordings relative to the baseline values, but during the phenylephrine infusion the blood flow velocity waveform indices for the uterine and placental arcuate arteries increased significantly and vascular resistance decreased significantly in the fetal renal arteries. Healthy fetuses seem to tolerate these changes in uteroplacental circulation well, however, since the Apgar scores for the newborns and the acid-base values in the umbilical cord were within the normal range in both groups. The results suggest that some caution is required when selecting the specific vasopressor agent, the dosage and the mode of administration for the treatment of maternal hypotension secondary to spinal anaesthesia for caesarean section.",
author = "Seppo Alahuhta and Juha Rasanen and Pentti Jouppila and Riitta Jouppila and Hollm{\'e}n, {Arno I.}",
year = "1992",
doi = "10.1016/0959-289X(92)90016-W",
language = "English (US)",
volume = "1",
pages = "129--134",
journal = "International Journal of Obstetric Anesthesia",
issn = "0959-289X",
publisher = "Churchill Livingstone",
number = "3",

}

TY - JOUR

T1 - Ephedrine and phenylephrine for avoiding maternal hypotension due to spinal anaesthesia for caesarean section. Effects on uteroplacental and fetal haemodynamics

AU - Alahuhta, Seppo

AU - Rasanen, Juha

AU - Jouppila, Pentti

AU - Jouppila, Riitta

AU - Hollmén, Arno I.

PY - 1992

Y1 - 1992

N2 - The effects of i.v. vasopressors on Doppler velocimetry of the maternal uterine and placental arcuate arteries and the fetal umbilical, renal and middle cerebral arteries were studied during spinal anaesthesia in 19 healthy parturients undergoing elective caesarean section. Fetal myocardial function was investigated at the same time by M-mode echocardiography. The patients were randomized into two groups, to be given either ephedrine or phenylephrine as a prophylactic infusion supplemented with minor boluses if systolic arterial pressure decreased by more than 10 mmHg from the control value. Both the vasopressors restored maternal arterial pressure effectively. The ephedrine group showed no significant differences in any of the Doppler velocimetry recordings relative to the baseline values, but during the phenylephrine infusion the blood flow velocity waveform indices for the uterine and placental arcuate arteries increased significantly and vascular resistance decreased significantly in the fetal renal arteries. Healthy fetuses seem to tolerate these changes in uteroplacental circulation well, however, since the Apgar scores for the newborns and the acid-base values in the umbilical cord were within the normal range in both groups. The results suggest that some caution is required when selecting the specific vasopressor agent, the dosage and the mode of administration for the treatment of maternal hypotension secondary to spinal anaesthesia for caesarean section.

AB - The effects of i.v. vasopressors on Doppler velocimetry of the maternal uterine and placental arcuate arteries and the fetal umbilical, renal and middle cerebral arteries were studied during spinal anaesthesia in 19 healthy parturients undergoing elective caesarean section. Fetal myocardial function was investigated at the same time by M-mode echocardiography. The patients were randomized into two groups, to be given either ephedrine or phenylephrine as a prophylactic infusion supplemented with minor boluses if systolic arterial pressure decreased by more than 10 mmHg from the control value. Both the vasopressors restored maternal arterial pressure effectively. The ephedrine group showed no significant differences in any of the Doppler velocimetry recordings relative to the baseline values, but during the phenylephrine infusion the blood flow velocity waveform indices for the uterine and placental arcuate arteries increased significantly and vascular resistance decreased significantly in the fetal renal arteries. Healthy fetuses seem to tolerate these changes in uteroplacental circulation well, however, since the Apgar scores for the newborns and the acid-base values in the umbilical cord were within the normal range in both groups. The results suggest that some caution is required when selecting the specific vasopressor agent, the dosage and the mode of administration for the treatment of maternal hypotension secondary to spinal anaesthesia for caesarean section.

UR - http://www.scopus.com/inward/record.url?scp=44049115984&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44049115984&partnerID=8YFLogxK

U2 - 10.1016/0959-289X(92)90016-W

DO - 10.1016/0959-289X(92)90016-W

M3 - Article

C2 - 15636811

AN - SCOPUS:44049115984

VL - 1

SP - 129

EP - 134

JO - International Journal of Obstetric Anesthesia

JF - International Journal of Obstetric Anesthesia

SN - 0959-289X

IS - 3

ER -