A COMPARATIVE EVALUATION OF FLUID PRELOADING VS. CO-LOADING ON MATERNAL HAEMODYNAMICS AND NEONATAL OUTCOME FOR THE PARTURIENTS UNDERGOING EMERGENCY CAESAREAN DELIVERY- A PROSPECTIVE, RANDOMISED, DOUBLE-BLIND, PARALLEL GROUP STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 25
Abstract
BACKGROUND Emergency caesarean section (CS) is very often done under spinal anaesthesia unless contraindicated. This neuraxial block results in hypotension caused by pharmacological sympathectomy. This effect can lead to cardiovascular side effects like hypotension, bradycardia, nausea, at the same time foetal jeopardy like foetal hypoxia and acidosis. These side effects can be prevented either by preloading with a crystalloid or simultaneous co-loading during intraoperative period. Here, in this prospective, double-blind study, we had compared the incidence of hypotension in intraoperative period and the foetal outcome in two groups. MATERIALS AND METHODS This prospective, randomised, double-blind, parallel group study was conducted in obstetric emergency OT of a tertiary care centre. 100 primigravida mothers aged between 18 - 29 years with ASA I physical status, posted for emergency CS due to foetal distress was randomly allocated for either preloading (Group P) or co-loading (Group C). RESULTS Fluid requirement was significantly less in co-loading group. There was no significant difference in the incidence of hypotension and ephedrine use. Foetal outcome in 1 min Apgar in Group C was significantly better, as the baby could be delivered quickly in Group C. CONCLUSION It is evident from our study that preloading can safely be avoided for spinal anaesthesia in CS posted for foetal distress. By using co-loading method, we can save valuable time required to deliver the baby and avoid circulatory overload without increasing incidence of hypotension.
Authors and Affiliations
Partha Sarathi Halder, Anjan Das, Debabrata Mandal, Hirak Biswas, Sandip Roy Basunia, Tapobrata Mitra, Surajit Chattopadhyay, Subrata Kumar Mandal
Keywords
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- EP ID EP450660
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