Maternal positioning affects fetal heart rate changes after epidural analgesia for labour.

Szczegóły
Abstrakt

Tytuł:: Maternal positioning affects fetal heart rate changes after epidural analgesia for labour.
Autorzy:: Preston, Roanne
Crosby, Edward
Kotarba, D.
Dudas, Helene
Elliott, Robert
Preston, R
Crosby, E T
Dudas, H
Elliott, R D
Temat:: AORTA physiology
VENAE cavae
BLOOD pressure
COMPARATIVE studies
FETAL distress
FETAL monitoring
HYPOTENSION
LABOR (Obstetrics)
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
NERVE block
PAIN
POSTURE
PRESSURE
RESEARCH
STATISTICAL sampling
SUPINE position
TIME
UTERUS
EVALUATION research
RANDOMIZED controlled trials
EPIDURAL analgesia
OBSTETRICAL analgesia
BUPIVACAINE
FETAL heart rate
PHYSIOLOGY
Źródło:: Canadian Journal of Anaesthesia / Journal Canadien d'Anesthésie; 1993, Vol. 40 Issue 12, p1136-1141, 6p
Abstract (English):: Adverse fetal heart rate (FHR) changes suggestive of fetal hypoxia are seen in patients with normal term pregnancies after initiation of epidural block for labour analgesia. It was our hypothesis that, in some parturients, these changes were a consequence of concealed aortocaval compression resulting in decreased uterine blood flow. We expected that the full lateral position compared with the wedged supine position would provide more effective prophylaxis against aortocaval compression. To test our hypothesis we studied the role of maternal positioning on FHR changes during onset of epidural analgesia for labour. Eighty-eight ASA Class I or II term parturients were randomized into two groups: those to be nursed in the wedged supine position and those to be nursed in the full lateral position during induction of an epidural block. External FHR monitoring was employed to assess the fetal response to initiation of labour epidural analgesia. Epidural catheters were sited with the parturients in the sitting position and the patients then assumed the study position. After a negative test dose, a standardized regimen of bupivacaine 0.25% was employed to provide labour analgesia. The quality and efficacy of the block were assessed using VAS pain scores, motor block scores and sensory levels. The results demonstrated that there was no difference in the quality of analgesia provided nor in the incidence of asymmetric blocks. There was no difference in the observed incidence of FHR changes occurring during the initiation of the epidural block.(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]
: Czasopismo naukowe

Copyright of Canadian Journal of Anaesthesia / Journal Canadien d'Anesthésie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Informacja