Maternal and uteroplacental haemodynamic state in pre-eclamptic patients during spinal anaesthesia for Caesarean section

Juha Karinen, Seppo Alahuhta, Riitta Jouppila, Juha Rasanen, Pentti Jouppila

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

We have studied the effects of crystalloid (Ringer's acetate 1 litre) preloading and subsequent spinal anaesthesia in 12 pre-eclamptic parturient patients undergoing elective Caesarean section. Maternal placental uterine artery circulation was measured using a pulsed colour Doppler technique with simultaneous measurement of maternal haemodynamic state. Despite preloading, mean maternal systolic arterial pressure (SAP) decreased significantly and marked maternal hypotension (SAP <80% of baseline value) was recorded in two patients after induction of spinal anaesthesia. Mean central venous pressure increased significantly after preload, but decreased to baseline shortly after induction of spinal anaesthesia. Mean pulsatility index (PI) in the uterine artery did not change during preload or spinal block. In one patient, uterine artery PI increased significantly when SAP decreased to 71% of the baseline value, 14 min after induction of spinal anaesthesia. These results suggest that preload with crystalloid solution does not prevent maternal hypotension in pre-eclamptic patients, and that changes in uterine artery velocity waveforms were minor when SAP was 80% or more of baseline during spinal anaesthesia. These changes did not appear to have any major effect on the clinical condition of the neonate, as assessed by Apgar score and umbilical artery pH values.

Original languageEnglish (US)
Pages (from-to)616-620
Number of pages5
JournalBritish Journal of Anaesthesia
Volume76
Issue number5
StatePublished - 1996
Externally publishedYes

Fingerprint

Spinal Anesthesia
Uterine Artery
Cesarean Section
Hemodynamics
Mothers
Arterial Pressure
Blood Pressure
Hypotension
Umbilical Arteries
Central Venous Pressure
Apgar Score
Color
Parturition
Newborn Infant
crystalloid solutions

Keywords

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

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Maternal and uteroplacental haemodynamic state in pre-eclamptic patients during spinal anaesthesia for Caesarean section. / Karinen, Juha; Alahuhta, Seppo; Jouppila, Riitta; Rasanen, Juha; Jouppila, Pentti.

In: British Journal of Anaesthesia, Vol. 76, No. 5, 1996, p. 616-620.

Research output: Contribution to journalArticle

Karinen, J, Alahuhta, S, Jouppila, R, Rasanen, J & Jouppila, P 1996, 'Maternal and uteroplacental haemodynamic state in pre-eclamptic patients during spinal anaesthesia for Caesarean section', British Journal of Anaesthesia, vol. 76, no. 5, pp. 616-620.
Karinen, Juha ; Alahuhta, Seppo ; Jouppila, Riitta ; Rasanen, Juha ; Jouppila, Pentti. / Maternal and uteroplacental haemodynamic state in pre-eclamptic patients during spinal anaesthesia for Caesarean section. In: British Journal of Anaesthesia. 1996 ; Vol. 76, No. 5. pp. 616-620.
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