A Randomized Prospective Study to Compare the Effect of Wedge, Manual Displacement of Uterus and no Intervention, to Reduce The Hemodynamic Effects of Aortocaval Compression in Parturients Undergoing Caesarean Section Under Subarachnoid Block
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 3
Abstract
Introduction: Aortocaval compression is an important cause of supine hypotension syndrome in the pregnant women. Subarachnoid block administered for Caesarean Section can further compound the hypotension and impairs uteroplacental circulation. Many methods have been evaluated to decrease degree of aortocaval compression during LSCS like left lateral tilt with wedge, tilting of operating table, mechanical or manual displacement of uterus. We have evaluated the effect of left lateral tilt with wedge, manual displacement of uterus and no intervention on pregnant women coming for lower segment Caesarean Section (LSCS) to decrease effect of aortocaval compression. Method: Parturients were randomly allocated into Group S: 30 parturients placed in supine position; Group W: 30 parturients had wedge placed under right side of pelvis Group MD: 30 parturients were given manual displacement of uterus to left side. Results: The incidence of hypotension post subarachnoid block (SAB) was highest in Group S i.e. 56.67% while it was similar in Group W and Group MD i.e. 26.67%.The mean (Standard Deviation) Mephentermine requirement in Group S was 4.6(4.4); Group W 1(2.3) while in Group MD 2(3.6) which is statistically significant p- 0.001.While the time to fall in SBP was not statistically different in all three groups. Conclusion: We found leftward tilt of uterus with wedge or manual displacement effectively reduces incidence of maternal hypotension and subsequent need for vasopressor. It is easier to put wedge. We conclude that all the parturients posted for caesarean section should have wedge placed under the right side of pelvis and lumbar region to decrease incidence of hypotension.
Authors and Affiliations
Vandana Pakhare, S Kalyani Surya Dhana Lakshmi, D Satya Sree, Ramakrishna Chaitanya K, Mahender Kannuri, B Nagarjuna
Keywords
Related Articles
- EP ID EP547776
- DOI 10.21276/ijmrp.2017.3.3.007
- Views 78
- Downloads 0
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